Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. WILLIAM DEAN WALLACE, M.D.
Active Sole ProprietorImmunopathology · MURRAY, UT
Registration Details
- NPI Number
- 1093143745
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 16, 2013 (12.515193687863 yrs)
- Last Updated
- Oct 16, 2013
- License
-
168418-1205 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
747 W 4170 SMURRAY, UT, 841231364Browse UT providers · Browse ZIP 84123
- Phone
- 8012606015
- Primary Specialty
-
Immunopathology
207ZI0100X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.