Wallace, Graham Wilson
Wallace, Graham Wilson is an individual health care provider with primary practice located at David Grant Medical Center 101 Bodin Circle, Travis Afb CA 94535-1809. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wallace, Graham Wilson can be contacted via phone (707) 423-3040.Contact Information
Primary practice address
David Grant Medical Center 101 Bodin Circle
Travis Afb CA 94535-1809
Phone: (707) 423-3040
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01051128A | Indiana |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01051128A | Indiana |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | C142217 | California |
Profile Details
NPI number | 1063499267 |
---|---|
LBN Legal business name | Wallace, Graham Wilson |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 29th, 2005 |
Last updated | Mar 4th, 2022 - about 2 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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