Individual
DR. ROBERT STEVEN WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 SAUNDERS HOLLOW RD, OLD LYME, CT 06371-1127
(860) 598-9160
Mailing address
55 SAUNDERS HOLLOW RD, OLD LYME, CT 06371-1127
(860) 598-9160
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
25MA07059900
NJ
207RI0200X
Infectious Disease Physician
Primary
49370
CT
207RI0200X
Infectious Disease Physician
MD037184
DC
Other
Enumeration date
05/11/2009
Last updated
08/10/2021
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