Individual
CLAIRE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2054 SYCAMORE AVE, BUENA VISTA, VA 24416-3124
(540) 261-1315
(540) 261-1314
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101260575
VA
207Q00000X
Family Medicine Physician
29915
OK
Other
Enumeration date
06/18/2013
Last updated
05/10/2023
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