Individual
MS. CHANTAL L WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 E COOLSPRING AVE STE 1C, MICHIGAN CITY, IN 46360-6312
(219) 861-5719
(219) 861-5774
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01052190A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198778
ANTHEM PROVIDER ID NO.
IN
05
—
200280630
—
IN
Enumeration date
08/15/2006
Last updated
12/04/2023
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