Individual
WALLACE J MICHALSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 HWY 31 NW, HARTSELLE, AL 35640
(256) 773-6017
(256) 773-7834
Mailing address
1211 HWY 31 NW, HARTSELLE, AL 35640
(256) 773-6017
(256) 773-7834
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8607
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001788
—
AL
01
—
51001788
BCBS
AL
Enumeration date
09/01/2006
Last updated
01/20/2010
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