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Individual

JAMES P WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 N 8TH AVE, SUITE 1A, DILLON, SC 29536-2549
(843) 774-2478
(843) 774-1826
Mailing address
PO BOX 512, DILLON, SC 29536-0512
(843) 774-2478
(843) 774-1826

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11072
SC

Other

Enumeration date
10/06/2006
Last updated
07/16/2012
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