Individual
DR. LEVY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 MAIN ST, DANBURY, CT 06810-7834
(203) 743-0100
Mailing address
120 MAIN ST, DANBURY, CT 06810-7834
(203) 743-0100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
323872
NY
207R00000X
Internal Medicine Physician
76990
CT
Other
Enumeration date
04/17/2020
Last updated
04/01/2024
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