Individual provider · Type 1 NPI
Michael Robert Wallace, DPM
Foot & Ankle Surgery Podiatrist · Valdosta, GA
NPI number
1295828416
Active
Practice location
2800 N Oak St
Valdosta, GA 31602-1716
Fax (229) 244-2721
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 599 (GA) |
Foot & Ankle Surgery Podiatrist: Definition to come...
3 other providers at this address
Other foot & ankle surgery podiatrist providers in Valdosta
About NPI 1295828416
Michael Robert Wallace, DPM's National Provider Identifier is 1295828416, issued on Oct 2, 2006. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Valdosta, GA. The record was last updated on Sep 18, 2013.