DR. Gregory L. Wallace, MD

NPI #1770712309 in Laramie, Wyoming

Provider Information

NPI Number: 1770712309
Entity Type: Individual
Name: DR. Gregory L. Wallace, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Anesthesiology
Credential: MD
Enumeration Date: Jul 2, 2009
Last Updated: Jul 1, 2013

Practice Location

Address: 204 MCCOLLUM DR
Address 2: SUITE 101
City: Laramie
State: Wyoming
ZIP Code: 82070-5151
Phone: (307) 745-6065

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Anesthesiology	207L00000X	Primary

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