Individual
DR. SIMON ANDREW WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
536 LIPPINCOTT DR, MARLTON, NJ 08053-4805
(856) 355-7155
(856) 325-4798
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-7155
(856) 325-4798
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
25MA12907600
NJ
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD477813
PA
208100000X
Physical Medicine & Rehabilitation Physician
25MA12907600
NJ
208100000X
Physical Medicine & Rehabilitation Physician
72026
WI
208100000X
Physical Medicine & Rehabilitation Physician
7636-851
WI
Other
Enumeration date
05/03/2017
Last updated
03/16/2026
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