Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRYAN MICHAEL WALLACE, SOIDC
ActiveBRYAN MICHAEL WALLACE, SOIDC is a Independent Duty Corpsman healthcare provider located in CAMP LEJEUNE, North Carolina. NPI 1336825926 is currently active in the NPPES registry. Verify at CMS.
Independent Duty Corpsman · CAMP LEJEUNE, NC
Registration Details
- NPI Number
- 1336825926
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 27, 2023 (3.1428153179509 yrs)
- Last Updated
- Jun 30, 2023
Practice Information
- Address
-
1ST MARINE RAIDER BATTALIONSTONE BAYCAMP LEJEUNE, NC, 28542Browse NC providers · Browse ZIP 28542
- Phone
- 9104402504
- Primary Specialty
-
Independent Duty Corpsman
1710I1002X
Other Independent Duty Corpsman Providers in CAMP LEJEUNE, NC
| Name | Credential | NPI |
|---|---|---|
| TIMOTHY NICHOLAS DITTLINGER | — | 1447227913 |
| CHARLES THOMAS CANTERBURY | HMCS - NAVY IDC | 1225005515 |
| CHARLES EDWARD TRANTHAM | — | 1376510370 |
| MR. GEORGE LEO KROW JR. | IDC | 1639147689 |
| MR. SHAWN THOMAS LAWSON LAWSON | IDC | 1174584783 |
| MR. EDWIN SOTO | IDC | 1508873092 |
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.