Individual
DANIEL JAY WALLACH
Active
Individual
DANIEL JAY WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD046458
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101264875
VIRGINIA
VA
01
—
MD046458
DISTRICT OF COLUMBIA
DC
Enumeration date
01/30/2015
Last updated
01/09/2019
Update your record
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