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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184850885 | NPPES |
| Arizona | MEDICAID | 948235 |
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