Basic Information
| Provider Information | |||||||||
| NPI: | 1417280231 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WALTER C LOCKHART | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1616 FOREST DR | ||||||||
| Address2: | #2 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214031019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102668663 | ||||||||
| FaxNumber: | 4102686000 | ||||||||
| Practice Location | |||||||||
| Address1: | 1616 FOREST DR | ||||||||
| Address2: | #2 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214031019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102668663 | ||||||||
| FaxNumber: | 4102686000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2009 | ||||||||
| LastUpdateDate: | 09/11/2009 | ||||||||
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| AuthorizedOfficialLastName: | LOCKHART | ||||||||
| AuthorizedOfficialFirstName: | WALTER | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICAN AND OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4434816476 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.