Wallace, Celeste Nicole

Wallace, Celeste Nicole is an individual health care provider with primary practice located at 802 Green Valley Rd Suite 210, Greensboro NC 27408-7041. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wallace, Celeste Nicole can be contacted via phone (336) 802-2536.

Contact Information

Primary practice address
802 Green Valley Rd Suite 210 Greensboro NC 27408-7041
Phone: (336) 802-2536
Fax: (336) 802-2534
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 34--008564 Ohio

Profile Details

NPI number 1740252576
LBN Legal business name Wallace, Celeste Nicole
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Jan 16th, 2013 - about 13 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 1740252576 NPPES
Ohio MEDICAID 2583520

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