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1265991335
PAUL MICHAEL WALLACE
PROVIDENCE, RI
NPI
1265991335
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: RI MD19363)
Enumeration Date
2019-03-18
Last Update Date
2023-10-10
Business Address
Dr. PAUL MICHAEL WALLACE MD
528 N MAIN ST
PROVIDENCE, RI 02904
Phone number: 401-528-0123
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Mailing Address
Dr. PAUL MICHAEL WALLACE MD
528 N MAIN ST
PROVIDENCE, RI 02904
Phone number: 401-528-0123
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