STEPHEN RUSSELL WALLACE

DURHAM, NC
NPI1194220061
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: NC  2023-00659)
Enumeration Date2018-03-24
Last Update Date2023-06-27
Business Address
STEPHEN RUSSELL WALLACE DO
2301 ERWIN RD
DURHAM, NC 27705-4699
Phone number: 919-684-8111
Mailing Address
STEPHEN RUSSELL WALLACE DO
PO BOX 63362
CHARLOTTE, NC 28263-3362
Phone number: