Individual
DR. JULIE A WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4444 ARLINGTON RD, UNIONTOWN, OH 44685-9508
(330) 896-6111
(330) 634-1329
Mailing address
3515 MASSILLON RD STE 300, UNIONTOWN, OH 44685-7854
(330) 899-9350
(330) 634-1329
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35073269
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
05
—
2166310
—
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
07/18/2005
Last updated
07/20/2020
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