Moira Petirs Wallace, M.D.
NPI #1053549212 in Jacksonville, Florida
Provider Information
- NPI Number
- 1053549212
- Entity Type
- Individual
- Name
- Moira Petirs Wallace, M.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Emergency Medicine
- Credential
- M.D.
- Enumeration Date
- Jun 26, 2009
- Last Updated
- Oct 26, 2023
Practice Location
- Address
- 3625 UNIVERSITY BLVD S
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32216-4207
- Phone
- (904) 702-6111
Specialties & Taxonomy Codes
| Specialty |
|---|
| Emergency Medicine |
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