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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740252576 | NPPES |
| Ohio | MEDICAID | 2583520 |
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