Parham, Walter A

Parham, Walter A is an individual health care provider with primary practice located at 2 Good Samaritan Way Suite 220, Mount Vernon IL 62864-2408. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Parham, Walter A can be contacted via phone (618) 899-3900.

Contact Information

Primary practice address
2 Good Samaritan Way Suite 220 Mount Vernon IL 62864-2408
Phone: (618) 899-3900
Fax: (618) 899-4786
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 036112518 Illinois
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036112518 Illinois

Profile Details

NPI number 1487646972
LBN Legal business name Parham, Walter A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487646972 NPPES
Illinois Other 0010032059 BCBS
Illinois MEDICAID 036112518 BCBS

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