MR. Shawn Michael Wallace, PA-C

NPI #1124614706 in Rio Rancho, New Mexico

Provider Information

NPI Number: 1124614706
Entity Type: Individual
Name: MR. Shawn Michael Wallace, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 17, 2020
Last Updated: Oct 28, 2022

Practice Location

Address: 2400 UNSER BLVD SE STE 08100
City: Rio Rancho
State: New Mexico
ZIP Code: 87124
Phone: (505) 253-6100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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