Individual
WALLACE ERIC CHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 N SYRINGA ST STE 100, POST FALLS, ID 83854-5275
(208) 262-2600
(208) 262-2700
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2300
(208) 262-2390
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-8003
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427041730
—
ID
Enumeration date
08/23/2005
Last updated
08/22/2024
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