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1609804525
DAVID WALLACE
BELLEVILLE, IL
NPI
1609804525
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: IL 036092919)
Enumeration Date
2006-06-29
Last Update Date
2017-04-17
Business Address
-- DAVID WALLACE M.D.
340 W LINCOLN ST
BELLEVILLE, IL 62220-1900
Phone number: 618-233-6044
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Mailing Address
-- DAVID WALLACE M.D.
340 W LINCOLN ST
BELLEVILLE, IL 62220-1900
Phone number: 618-233-6044
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