Individual
JOSEPH ROBERT WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
8218
AZ
363A00000X
Physician Assistant
Primary
AMD-1073
HI
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AMD-1073
STATE LICENSE
HI
Enumeration date
09/02/2020
Last updated
06/09/2022
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