Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariah Wallace, PA-C

Individual provider Physician Assistant · NPI 1124806682

Mariah Wallace, PA-C is a Physician Assistant in Mt Pleasant, Pennsylvania. Qualified in 2023, 3 years ago. Licensed in Pennsylvania.

Years since qualifying
3
Licensed in
PA
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

508 S Church St
Mt Pleasant, PA 15666-1702
Phone: (724) 547-7092
Fax: (724) 547-7096
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA067651 (PA)

Record details

NPI number1124806682
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 18, 2023
Last updated in NPPESMay 15, 2026
Certification dateMay 15, 2026
Mailing address508 S Church St, Mt Pleasant, PA 15666-1702

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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