Wallace, Eric Lee

Wallace, Eric Lee is an individual health care provider with primary practice located at 1450 Matthews Township Pkwy Ste 250 , Matthews NC 28105-5331. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wallace, Eric Lee can be contacted via phone (704) 841-1444.

Contact Information

Primary practice address
1450 Matthews Township Pkwy Ste 250 Matthews NC 28105-5331
Phone: (704) 841-1444
Fax: (704) 849-2520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2006-00806 North Carolina

Profile Details

NPI number 1780614529
LBN Legal business name Wallace, Eric Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Aug 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780614529 NPPES
North Carolina MEDICAID 5904040

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