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George F. Wallace, DPM
Foot & Ankle Surgery Podiatrist in Newark, New Jersey
NPI 1811001696

George F. Wallace is a Foot & Ankle Surgery Podiatrist based in Newark, NJ and is specialized in Foot & Ankle Surgery. George F. Wallace practices in Newark, NJ and has the professional credentials of DPM. The NPI Number for George F. Wallace is 1811001696 and holds a License No. 25MD00137200 (New Jersey).

The current practice location address for George F. Wallace is 90 Bergen St, Newark, NJ and can be reached out via phone at 973-972-2500 and via fax at 973-972-2510.

Location: 90 Bergen St, Newark, NJ, 07107-3000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811001696
Provider Name
George F. Wallace
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
90 Bergen St, Newark, NJ, 07107-3000
Phone Number
973-972-2500
Fax Number
973-972-2510
Provider Enumeration Date
08/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1567101 05 NJ
institution
Provider Business Practice Location Address Details
Address
90 Bergen St
City
Newark
State
New Jersey
Zip
07103-2425
Phone Number
973-972-2500
Fax Number
973-972-2510
person
Provider Business Mailing Address Details
Address
90 Bergen St
City
Newark
State
New Jersey
Zip
07103-2425
Phone Number
973-972-2500
Fax Number
973-972-2510
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
25MD00137200 (New Jersey)
Definition
Definition to come...
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