Individual provider · Type 1 NPI

Shana Dale Wallace, MD

Neurology with Special Qualifications in Child Neurology Physician · Charlotte, NC

NPI number 1013040666 Active

Practice location

1900 Randolph Rd, Suite 1010
Charlotte, NC 28207-1122

Call (704) 384-1390 Map

Fax (704) 384-1063

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Specialties and licenses

TaxonomyCodeLicense
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X2004-01063 (NC)
Neurology with Special Qualifications in Child Neurology Physician Primary 2084N0402X200401063 (NC)

Neurology with Special Qualifications in Child Neurology Physician: A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

50 other providers at this address

Other neurology with special qualifications in child neurology physician providers in Charlotte

See all in Charlotte →

About NPI 1013040666

Shana Dale Wallace, MD's National Provider Identifier is 1013040666, issued on Mar 13, 2007. The primary taxonomy on file is Neurology with Special Qualifications in Child Neurology Physician (2084N0402X), and the practice location is in Charlotte, NC. The record was last updated on Oct 25, 2020.