Individual
WALTER MADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4801 DORSEY HALL DR, SUITE 130, ELLICOTT CITY, MD 21042-7766
(410) 730-9851
(410) 730-9855
Mailing address
4801 DORSEY HALL DR, SUITE 130, ELLICOTT CITY, MD 21042-7766
(410) 730-9851
(410) 730-9855
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
15340
MD
2251X0800X
Orthopedic Physical Therapist
Primary
15340
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236397
MAMSI
MD
01
—
6545-0003
BLUE CHOICE
MD
Enumeration date
09/26/2005
Last updated
12/09/2008
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