Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MAURA KATHLEEN WALLACE, PHYSICIAN ASSISTANT
Active Sole ProprietorMAURA KATHLEEN WALLACE, PHYSICIAN ASSISTANT is a Medical Physician Assistant healthcare provider located in WORTHINGTON, Ohio. NPI 1881459667 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · WORTHINGTON, OH
Registration Details
- NPI Number
- 1881459667
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 20, 2024 (2.4407665075845 yrs)
- Last Updated
- Apr 28, 2025
- License
-
50.008630 (OH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
874 PROPRIETORS RDWORTHINGTON, OH, 430853152Browse OH providers · Browse ZIP 43085
- Phone
- 6148859405
- Fax
- 6148859481
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
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.