Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Trevor Dewitt Wallace

Individual provider Contractor · NPI 1003339094

Trevor Dewitt Wallace is a Contractor in Suwanee, Georgia. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since
2017
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Practice location Address checks out

571 Eva Kennedy Rd Apt 8
Suwanee, GA 30024-3008
Phone: (770) 369-1497
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1003339094
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 20, 2017
Last updated in NPPESJuly 21, 2022
Mailing address571 Eva Kennedy Rd Apt 8, Suwanee, GA 30024-3008

Other providers in Suwanee