Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ALEXIS NICOLE WALLACE, MD
ActiveALEXIS NICOLE WALLACE, MD is a Internal Medicine healthcare provider located in 1120 15TH ST, Georgia. NPI 1245856822 is currently active in the NPPES registry. Verify at CMS.
Internal Medicine · 1120 15TH ST, GA
Registration Details
- NPI Number
- 1245856822
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 19, 2020 (6.186829120158 yrs)
- Last Updated
- Dec 15, 2021
- Licenses
-
LL84507 (SC)12864 (GA)
Practice Information
- Address
-
AUGUSTA UNIVERSITY MEDICAL CENTER1120 15TH ST, GA, 30912Browse GA providers · Browse ZIP 30912
- Phone
- 7067212273
- Primary Specialty
-
Internal Medicine
207R00000X
- Additional Specialty
- Internal Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.