Search › New York › 207Q00000X
Gregory Wallace, D.O
NPI 1558701250 · on the registry since 2013
Practice
- Address
- 11050 Mount Belvedere Blvd
Fort Drum, NY 13602 - Phone
- (315) 772-5662
- Organisation at this address
- Us Army
Ahc Guthrie-DrumInferred from a shared address, not stated in the registry. - Clinicians at this address
- 155
Additional practice sites
- 2817 Reilly St, Fort Bragg, NC
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 390200000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-07-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York