Wallace, Heath Wade

Wallace, Heath Wade is an individual health care provider with primary practice located at Uss Theodore Roosevelt Cvn 71 Medical Department, Fpo AE 09599-2871. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Wallace, Heath Wade can be contacted via phone (757) 445-6230.

Contact Information

Primary practice address
Uss Theodore Roosevelt Cvn 71 Medical Department Fpo AE 09599-2871
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1558323725
LBN Legal business name Wallace, Heath Wade
Credentials IDC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Apr 20th, 2008 - about 16 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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