Individual provider · Type 1 NPI
Anya Wallace, PA-C
Medical Physician Assistant · Charlotte, NC
NPI number
1609264373
Active
Practice location
309 S Sharon Amity Rd., Suite 206
Charlotte, NC 28211
Fax (980) 273-1102
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 0010-05473 (NC) |
| Medical Physician Assistant Primary | 363AM0700X | 0010-05473 (NC) |
Medical Physician Assistant: Definition to come...
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About NPI 1609264373
Anya Wallace, PA-C's National Provider Identifier is 1609264373, issued on Jan 5, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Charlotte, NC. The record was last updated on Jul 14, 2021.