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1336116656
DAVID M WALLACE
LONG BRANCH, NJ
NPI
1336116656
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine
(Licence: NJ 25MA04221200)
Enumeration Date
2006-03-06
Last Update Date
2011-10-14
Business Address
-- DAVID M WALLACE M.D.
73 S BATH AVE
LONG BRANCH, NJ 07740-5725
Phone number: 732-870-3600
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Mailing Address
-- DAVID M WALLACE M.D.
PO BOX 8000 DEPT 596
BUFFALO, NY 14267-0002
Phone number: 866-295-0041
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