Individual
MR. MICHAEL WADE GILLESPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 BROOKSIDE DRIVE, WALLA WALLA, WA 99362
(509) 525-1890
Mailing address
101 BROOKSIDE DRIVE, WALLA WALLA, WA 99362
(509) 525-1890
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
14620
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1304203
—
WA
Enumeration date
10/22/2013
Last updated
10/22/2013
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