Individual
DR. MICHAEL H WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
788 8TH AVENUE SE, SUITE 204, CEDAR RAPIDS, IA 52401
(319) 398-6342
(319) 558-0330
Mailing address
788 8TH AVENUE SE, SUITE 204, MERCY EMPLOYEE HEALTH CENTER, CEDAR RAPIDS, IA 52401
(319) 398-6342
(319) 558-0330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37120
IA
Other
Enumeration date
10/04/2006
Last updated
06/16/2021
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