Wallace, Suemoy S

Wallace, Suemoy S is an individual health care provider with primary practice located at 2945 S Dobson Rd , Mesa AZ 85202-7941. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery, Other Service Providers / Specialist. Other Service Providers / Specialist is her primary health care specialty. Wallace, Suemoy S can be contacted via phone (480) 969-4138.

Contact Information

Primary practice address
2945 S Dobson Rd Mesa AZ 85202-7941
Phone: (480) 969-4138
Fax: (480) 969-0630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 49311 Arizona
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 49311 Arizona
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 49311 Arizona
Other Service Providers / Specialist 174400000X 49311 Arizona

Profile Details

NPI number 1184850885
LBN Legal business name Wallace, Suemoy S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2009
Last updated May 18th, 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 1184850885 NPPES
Arizona MEDICAID 948235

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