Wallace, Stephen G
Wallace, Stephen G is an individual health care provider with primary practice located at 350 Young Ave Ste 200 , Moorestown NJ 08057-3146. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Wallace, Stephen G can be contacted via phone (609) 702-1900.Contact Information
Primary practice address
350 Young Ave Ste 200
Moorestown NJ 08057-3146
Phone: (609) 702-1900
Fax: (609) 702-8455
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | MA079166 | New Jersey |
Profile Details
| NPI number | 1144255498 |
|---|---|
| LBN Legal business name | Wallace, Stephen G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Oct 19th, 2021 - about 4 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 | 1144255498 | NPPES |
| Other | 3982071 | AETNA | |
| MEDICAID | 0068837 | AETNA |
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