Individual
DR. NOAH ISADORE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
502 W BROAD ST STE 2, FALLS CHURCH, VA 22046-3206
(571) 421-8431
Mailing address
633 MEDICAL GROUP, 77 NEALY AVE, LANGLEY AFB, VA 23665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102205033
VA
Other
Enumeration date
06/25/2015
Last updated
05/23/2025
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