Individual
WALLY FERNANDO JAIMES GARCES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(256) 551-4631
Mailing address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(256) 551-4631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L.3201R
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/14/2010
Last updated
02/24/2012
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