Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GREGORY WALLACE, D.O.
ActiveGREGORY WALLACE, D.O. is a Family Medicine healthcare provider located in FORT DRUM, New York. NPI 1558701250 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · FORT DRUM, NY
Registration Details
- NPI Number
- 1558701250
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 27, 2013 (13.143615500842 yrs)
- Last Updated
- Jul 27, 2018
- License
-
02004547A (IN)
Practice Information
- Address
-
11050 MOUNT BELVEDERE BLVDFORT DRUM, NY, 13602Browse NY providers · Browse ZIP 13602
- Phone
- 3157725662
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in FORT DRUM, NY
| Name | Credential | NPI |
|---|---|---|
| DR. DEAN C PEDERSEN | M.D. | 1760471015 |
| DR. DENNIS M SULLIVAN | M.D. | 1992795686 |
| DR. S. FOLLEY DUNNA | M.D. | 1861473118 |
| DR. PHILLIP J TODD | D.O | 1245218189 |
| CHRISTIAN JAMES MEKO | MD | 1952370751 |
| DR. ELIZABETH DUQUE | M.D. | 1023115664 |
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.