Individual
MARK M WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 E LASALLE, EMERGENCY DEPARTMENT, SOUTH BEND, IN 46617-2814
(574) 237-7111
(574) 273-1137
Mailing address
3371 CLEVELAND RD, SUITE 210, SOUTH BEND, IN 46628-9780
(574) 271-2558
(574) 273-1137
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
01035916A
IN
207R00000X
Internal Medicine Physician
01035916A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100318660
—
IN
Enumeration date
10/25/2005
Last updated
10/15/2008
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