Basic Information
| Provider Information | |||||||||
| NPI: | 1043491483 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALSON | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | HALLERMEIER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 127 CANDLER OAKS LN | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300303771 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5901C PEACHTREE DUNWOODY RD NE # C | ||||||||
| Address2: | STE C-65 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303285382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042529751 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2007 | ||||||||
| LastUpdateDate: | 08/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD426466 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | 061015 | GA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.