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Individual

DR. COREY J WALLACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
MD425770
PA
207X00000X
Orthopaedic Surgery Physician
A95705
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
0101241156
VA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A95705
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101239845
PA
Enumeration date
02/27/2006
Last updated
03/19/2026
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