Wallace B Carroll, MD

NPI #1003874124 in Modesto, California

Provider Information

NPI Number: 1003874124
Entity Type: Individual
Name: Wallace B Carroll, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Allergy & Immunology - Allergy
Credential: MD
Enumeration Date: May 1, 2006
Last Updated: May 28, 2010

Practice Location

Address: 600 COFFEE RD
City: Modesto
State: California
ZIP Code: 95355-4201
Phone: (209) 524-1211

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Allergy & Immunology - Allergy — Allergy	207KA0200X	Primary
Pediatrics	208000000X

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