Individual
FEBE IRIS WALLACE
Active
Individual
FEBE IRIS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD23950
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3889885
—
TN
Enumeration date
12/23/2005
Last updated
09/29/2020
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