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

Sidiqat Wallace

Individual provider Other Technician · NPI 1629843552

Sidiqat Wallace is an Other Technician in Charlotte, North Carolina. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

525 N Tryon St Ste 1600
Charlotte, NC 28202-0213
Phone: (855) 832-6727
Show map & directions

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

Specialties & licences

Other Technician (primary) Taxonomy 247200000X

Record details

NPI number1629843552
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 21, 2023
Last updated in NPPESMay 1, 2025
Certification dateMay 1, 2025
Mailing address525 N Tryon St Ste 1600, Charlotte, NC 28202-0213

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