Provider Demographics
NPI:1710792254
Name:WALKER, EARNEST III
Entity type:Individual
Prefix:
First Name:EARNEST
Middle Name:
Last Name:WALKER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 LEDYARD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2641
Mailing Address - Country:US
Mailing Address - Phone:313-962-9446
Mailing Address - Fax:313-502-5147
Practice Address - Street 1:445 LEDYARD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2641
Practice Address - Country:US
Practice Address - Phone:313-962-9446
Practice Address - Fax:313-502-5147
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator