Individual
DR. GENE AMBROSE WALLIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 BREWSTER BLVD, OCCUPATIONAL HEALTH CLINIC-BLDG 65, CAMP LEJEUNE, NC 28547-2538
(910) 451-5707
(910) 451-3766
Mailing address
1118 TWO MILE CIR W, WILMINGTON, NC 28405-4125
(910) 509-1784
(910) 509-1784
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15347
NC
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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