Individual
DR. DAVID MICHAEL WALLACE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 EATON ST, HAMPTON, VA 23669-4000
(757) 726-5000
(757) 726-5001
Mailing address
200 EATON ST, HAMPTON, VA 23669-4000
(757) 726-5000
(757) 726-5001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101269450
VA
207Q00000X
Family Medicine Physician
043144
GA
Other
Enumeration date
12/28/2006
Last updated
09/18/2020
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