Individual
DR. HOWARD S WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
37450 DEQUINDRE RD, STERLING HEIGHTS, MI 48310-3503
(586) 979-5100
(586) 979-6198
Mailing address
37450 DEQUINDRE RD, STERLING HEIGHTS, MI 48310-3503
(586) 979-5100
(586) 979-6198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301038416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301038416
LICENSE NUMBER
MI
Enumeration date
06/01/2010
Last updated
02/10/2011
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