Michael Anthony Wallace, IDC
Michael Anthony Wallace, IDC is an Independent Duty Corpsman in Portsmouth, Virginia. Registered with an NPI since 2008.
- In the registry since
- 2008
Practice location Address checks out
620 John Paul Jones CirPortsmouth, VA 23708-2111
Phone: (757) 953-6505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X |
|---|
Record details
| NPI number | 1427216837 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | IDC |
| Sole proprietor | No |
| NPI enumerated | June 2, 2008 |
| Last updated in NPPES | June 23, 2011 |
| Mailing address | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 |
Other providers in Portsmouth
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Eric Thomas Shank, IDC
620 John Paul Jones Cir, Portsmouth, VA 23708-2111 · (757) 953-8895
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Mr. Eric Nmn Smith
620 John Paul Jones Cir, Portsmouth, VA 23708-2111 · (757) 953-0515
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Mr. Francis M Thomas, IDC
620 John Paul Jones Cir, Portsmouth, VA 23708-2111 · (757) 953-8883
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Mr. Ricardo Miguel Tubbs, IDC
1001 Holcomb Rd, Portsmouth, VA 23708-2415 · (757) 953-5047