Holland, Wallace Earl

Holland, Wallace Earl is an individual health care provider with primary practice located at 10055 Ford Ave Suite 5A, Richmond Hill GA 31324-3972. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Holland, Wallace Earl can be contacted via phone (912) 756-2020.

Contact Information

Primary practice address
10055 Ford Ave Suite 5A Richmond Hill GA 31324-3972
Phone: (912) 756-2020
Fax: (912) 756-3187
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 024438 Georgia

Profile Details

NPI number 1972501799
LBN Legal business name Holland, Wallace Earl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Oct 5th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972501799 NPPES
South Carolina MEDICAID G24438
South Carolina Other 681687

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