Individual provider · Type 1 NPI

Moira Petirs Wallace, MD

Emergency Medicine Physician · Jacksonville, FL

NPI number 1053549212 Active

Practice location

3625 University Blvd S
Jacksonville, FL 32216-4207

Call (904) 702-6111 Map

Mailing address

830-13 A1A North, 232
Ponte Vedra, FL 32082

Other practice locations

  • 1555 Soquel Dr, Santa Cruz, CA 95065-1705 · (831) 462-7501

Specialties and licenses

TaxonomyCodeLicense
Emergency Medicine Physician 207P00000XA120516 (CA)
Emergency Medicine Physician Primary 207P00000XME133941 (FL)

Emergency Medicine Physician: An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in respo…

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About NPI 1053549212

Moira Petirs Wallace, MD's National Provider Identifier is 1053549212, issued on Jun 26, 2009. The primary taxonomy on file is Emergency Medicine Physician (207P00000X), and the practice location is in Jacksonville, FL. The record was last updated on Oct 26, 2023.