Individual
MR. CARTER DOUGLAS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 HAMILTON RD STE B, COLUMBUS, GA 31904-8856
(706) 655-8800
(205) 638-7455
Mailing address
1600 7TH AVENUE SOUTH, SUITE S604, BIRMINGHAM, AL 35233
(205) 638-9918
(205) 638-7455
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD.35643
AL
2080P0206X
Pediatric Gastroenterology Physician
Primary
90501
GA
2080P0206X
Pediatric Gastroenterology Physician
MD.35643
AL
Other
Enumeration date
09/13/2011
Last updated
08/22/2022
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