Wallace, Amber Ann
Wallace, Amber Ann is an individual health care provider with primary practice located at 1686 Skylyn Dr Suite 101, Spartanburg SC 29307. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Wallace, Amber Ann can be contacted via phone (864) 560-3456.Contact Information
Primary practice address
1686 Skylyn Dr Suite 101
Spartanburg SC 29307
Phone: (864) 560-3456
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 2012-01577 | North Carolina |
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | MD35398 | South Carolina |
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 01063765A | Indiana |
Profile Details
| NPI number | 1104035526 |
|---|---|
| LBN Legal business name | Wallace, Amber Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2007 |
| Last updated | May 16th, 2023 - about last year |
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 | 1104035526 | NPPES |
| South Carolina | Other | SC07926162 | MEDICARE PIN |
| South Carolina | Other | P01330093 | MEDICARE PIN |
| South Carolina | MEDICAID | NC1735 | MEDICARE PIN |
| South Carolina | Other | SC07923365 | MEDICARE PIN |
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