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Individual
DR. AFRICA F. WALLACE
Active
Individual
DR. AFRICA F. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD427591
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
070603
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
25MA10677300
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD427591
PA
Other
Enumeration date
08/05/2006
Last updated
04/22/2021
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