DR. Shana Dale Wallace, MD
NPI #1013040666 in Charlotte, North Carolina
Provider Information
- NPI Number
- 1013040666
- Entity Type
- Individual
- Name
- DR. Shana Dale Wallace, MD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology
- Credential
- MD
- Enumeration Date
- Mar 13, 2007
- Last Updated
- Oct 25, 2020
Practice Location
- Address
- 1900 RANDOLPH RD
- Address 2
- SUITE 1010
- City
- Charlotte
- State
- North Carolina
- ZIP Code
- 28207-1122
- Phone
- (704) 384-1390
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics - Neurodevelopmental Disabilities — Neurodevelopmental Disabilities |
| Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology — Neurology with Special Qualifications in Child Neurology |
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