Individual
SAMUEL J WALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204
(509) 474-3181
Mailing address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-3181
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD60851653
WA
207L00000X
Anesthesiology Physician
TL.0005746
CO
207R00000X
Internal Medicine Physician
BP10050008
TX
Other
Enumeration date
04/28/2014
Last updated
06/11/2018
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