Individual
DR. BRIAN SCOTT WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(484) 862-3232
(484) 862-3250
Mailing address
PO BOX 1754, ALLENTOWN, PA 18105-1754
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036120375
IL
207P00000X
Emergency Medicine Physician
Primary
MD453343
PA
Other
Enumeration date
05/18/2008
Last updated
12/24/2014
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