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Individual

DIANE WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
149 NE 241 ST, CROSS CITY, FL 32628-3305
(352) 498-1360
(352) 498-1359
Mailing address
23708 NW 194TH DR, HIGH SPRINGS, FL 32643-7022
(386) 454-2270

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0047108
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036568800
FL
01
04488
BCBS
FL
01
P00096973
RAILROAD MCR
FL
Enumeration date
09/14/2006
Last updated
05/06/2010
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