Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GABRIEL WAYNE WALLACE
Active Sole ProprietorGABRIEL WAYNE WALLACE is a Foot & Ankle Surgery healthcare provider located in PRESCOTT, Michigan. NPI 1932571056 is currently active in the NPPES registry. Verify at CMS.
Foot & Ankle Surgery · PRESCOTT, MI
Registration Details
- NPI Number
- 1932571056
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 28, 2015 (10.804436693476 yrs)
- Last Updated
- Oct 28, 2015
- License
-
7666037 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5208 MICHIBAN AVE.PRESCOTT, MI, 48756Browse MI providers · Browse ZIP 48756
- Phone
- 9893059629
- Fax
- 9898731225
- Primary Specialty
-
Foot & Ankle Surgery
3747P1801X
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.