person
John A. Wallace, DPM
Primary Podiatric Medicine Podiatrist in Merchantville, New Jersey
NPI 1861426462

John A. Wallace is a Primary Podiatric Medicine Podiatrist based in Merchantville, NJ and is specialized in Primary Podiatric Medicine. John A. Wallace practices in Merchantville, NJ and has the professional credentials of DPM. The NPI Number for John A. Wallace is 1861426462 and holds a License No. MD00151900 (New Jersey).

The current practice location address for John A. Wallace is 702 W Maple Ave, Merchantville, NJ and can be reached out via phone at 856-665-1180 and via fax at 856-665-5537.

Location: 702 W Maple Ave, Merchantville, NJ, 08109-1822
person
Provider Profile Details
NPI Number
1861426462
Provider Name
John A. Wallace
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
702 W Maple Ave, Merchantville, NJ, 08109-1822
Phone Number
856-665-1180
Fax Number
856-665-5537
Provider Enumeration Date
07/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6574009 05 NJ
0425672000 01 NJ AMERIHEALTH
institution
Provider Business Practice Location Address Details
Address
702 W Maple Ave
City
State
Zip
08109-1822
Phone Number
856-665-1180
Fax Number
856-665-5537
person
Provider Business Mailing Address Details
Address
702 W Maple Ave
City
State
Zip
08109-1822
Phone Number
856-665-1180
Fax Number
856-665-5537
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
License No.
MD00151900 (New Jersey)
Definition
Definition to come...
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