Individual
DR. MAEGEN J WALLACE
Active
Individual
DR. MAEGEN J WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
69950
AZ
207XP3100X
Pediatric Orthopaedic Surgery Physician
28403
NE
390200000X
Student in an Organized Health Care Education/Training Program
2008018502
MO
Other
Enumeration date
07/12/2008
Last updated
06/30/2023
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