Individual
LISA MARIA WALKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3615 CHESTNUT ST, PHILADELPHIA, PA 19104
(215) 662-2746
(215) 349-5648
Mailing address
3615 CHESTNUT ST, PHILADELPHIA, PA 19104-2612
(215) 662-2746
(215) 349-5648
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD463909
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001389891
—
CT
Enumeration date
11/22/2005
Last updated
06/06/2018
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