Individual
STEPHEN BLAKE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3055 ROSLYN ST UNIT 200, DENVER, CO 80238-3324
(303) 724-7378
Mailing address
10361 E 28TH PL, DENVER, CO 80238-3051
(225) 572-6083
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
DR.0063577
CO
Other
Enumeration date
04/13/2015
Last updated
07/29/2020
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