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1154949402
WALLACE PHILIP SHAW
BETHESDA, MD
NPI
1154949402
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: MD D-48403)
Enumeration Date
2020-07-13
Last Update Date
2020-07-13
Business Address
WALLACE PHILIP SHAW BM BCh PhD
CLINICAL CENTER NIH
BETHESDA, MD 20892-0001
Phone number: 202-679-6003
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Mailing Address
WALLACE PHILIP SHAW BM BCh PhD
1730 NEW HAMPSHIRE AVE NW APT 19
WASHINGTON, DC 20009-2545
Phone number: 202-679-6003
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