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Individual

DR. TRAVELYAN MARCEL WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1404 RIVER PL STE 201, BRASELTON, GA 30517-5600
(770) 219-9200
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
40509
SC
208600000X
Surgery Physician
Primary
69999
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
405092
SC
Enumeration date
07/28/2008
Last updated
12/08/2020
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