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

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