| Grant Michael Wallenfelsz, MD | |
| Bldg #50 Farenholt Ave, Agana Heights, GU 96910 | |
| (671) 344-9340 | |
| Not Available | 
| Full Name | Grant Michael Wallenfelsz | 
|---|---|
| Gender | Male | 
| Speciality | Emergency Medicine | 
| Location | Bldg #50 Farenholt Ave, Agana Heights, Guam | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1194353318 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207P00000X | Emergency Medicine | T3715 (Texas) | Primary | 
| 207P00000X | Emergency Medicine | A187218 (California) | Secondary | 
| 207P00000X | Emergency Medicine | M-2480 (Guam) | Secondary | 
| Entity Name | Cep America - California | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1548667843 PECOS PAC ID: 6103739131 Enrollment ID: O20040121000458 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Grant Michael Wallenfelsz, MD Psc 455 Box 208, Fpo, AP 96540-0003 Ph: () - | Grant Michael Wallenfelsz, MD Bldg #50 Farenholt Ave, Agana Heights, GU 96910 Ph: (671) 344-9340 | 
| Mallori Marie Wilson,  Emergency Medicine Medicare: Medicare Enrolled Practice Location: U.s. Naval Hospital Guam, Agana Heights, GU 96910 Phone: 671-344-9340 | |
| Dr. Thomas C Baugh, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: U.s. Naval Hospital Guam, Farenholt Street, Building K-1, Agana Heights, GU 96919 Phone: 671-344-9232 | |
| Dr. Alexander Janson Salazar, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: Farenholt Ave, Bldg 50, Agana Heights, GU 96910 Phone: 671-344-9232 | |
| Dr. Christopher Boyd Chisholm, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: Us Naval Hospital Guam, Farenholt Ave Bld K1, Agana Heights, GU 96919 Phone: 671-344-9619 | |
| Dr. John T Haggerty, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: Bldg 50, Farenholt Ave, Agana Heights, GU 96910 Phone: 671-344-9340 | |
| Daniel Rupert Neren, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: U.s. Naval Hospital Guam, Bldg 50, Farenholt Ave, Agana Heights, GU 96910 Phone: 671-344-9340 |