Individual
WALLACE NICHOLAS WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19748 MICHAELIS ROAD, DORRANCE, KS 67634
(785) 666-4341
(785) 666-4341
Mailing address
19748 MICHAELIS ROAD, DORRANCE, KS 67634
(785) 666-4341
(785) 666-4341
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0414492
KS
207ND0101X
MOHS-Micrographic Surgery Physician
0414492
KS
207ND0900X
Dermatopathology Physician
0414492
KS
Other
Enumeration date
09/07/2006
Last updated
11/19/2009
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