Individual
SUZANNE WATSON WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
832 PRINCETON AVE SW, BIRMINGHAM, AL 35211-1320
(205) 206-8480
(205) 206-8448
Mailing address
832 PRINCETON AVE SW, BIRMINGHAM, AL 35211-1320
(205) 206-8219
(205) 206-8300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.39283
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2017
Last updated
06/18/2020
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