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1932104205
MARK RANDALL WALLACE
SCOTTSDALE, AZ
NPI
1932104205
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: AZ 19816)
Enumeration Date
2005-06-14
Last Update Date
2020-09-03
Business Address
Dr. MARK RANDALL WALLACE MD
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259
Phone number: 480-301-8000
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Mailing Address
Dr. MARK RANDALL WALLACE MD
13400 E SHEA BLVD
SCOTTSDALE, AZ 85259-5452
Phone number: 480-301-8000
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