Individual
KEVIN WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(443) 444-8000
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C04094
MD
Other
Enumeration date
10/30/2009
Last updated
10/30/2009
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