DR. Mark Randall Wallace, MD

NPI #1932104205 in Scottsdale, Arizona

Provider Information

NPI Number
1932104205
Entity Type
Individual
Name
DR. Mark Randall Wallace, MD
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Internal Medicine
Credential
MD
Enumeration Date
Jun 14, 2005
Last Updated
Sep 3, 2020

Practice Location

Address
13400 E SHEA BLVD
State
Arizona
ZIP Code
85259
Phone
(480) 301-8000

Specialties & Taxonomy Codes

Specialty
Internal Medicine

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