Individual
TROY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1249 15TH ST, HUNTINGTON, WV 25701-3662
(304) 691-1000
(304) 691-1695
Mailing address
1249 15TH ST, HUNTINGTON, WV 25701-3662
(304) 691-1000
(304) 691-1695
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30460
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2017
Last updated
11/18/2021
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