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Individual

WALTER A PARHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2 GOOD SAMARITAN WAY, SUITE 220, MOUNT VERNON, IL 62864-2408
(618) 899-3900
(618) 899-4786
Mailing address
2 GOOD SAMARITAN WAY, SUITE 220, MOUNT VERNON, IL 62864-2408
(618) 899-3900
(618) 899-4786

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036112518
IL
207RI0011X
Interventional Cardiology Physician
036112518
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010032059
BCBS
IL
05
036112518
IL
Enumeration date
08/19/2005
Last updated
03/07/2023
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