Individual provider · Type 1 NPI

Wallace Maxwell Green, PAC

Neurology Physician · Fayetteville, GA

NPI number 1306979059 Active

Practice location

1275 Highway 54 W, STE.105
Fayetteville, GA 30214-4549

Call (770) 719-2965 Map

Fax (770) 719-2963

Specialties and licenses

TaxonomyCodeLicense
Neurology Physician Primary 2084N0400X001827 (GA)

Neurology Physician: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

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About NPI 1306979059

Wallace Maxwell Green, PAC's National Provider Identifier is 1306979059, issued on Mar 13, 2007. The primary taxonomy on file is Neurology Physician (2084N0400X), and the practice location is in Fayetteville, GA. The record was last updated on Jul 8, 2007.