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Moira Wallace, M.D
NPI 1053549212 · on the registry since 2009 · sole proprietor
Practice
- Address
- 3625 University Blvd S
Jacksonville, FL 32216 - Phone
- (904) 702-6111
- Organisation at this address
- Raul Orta Md Pa
Memorial Hospital
Mark C Monroe Md Pa
Diane W Chung Md Pa
Peter L Kovacs Md PaInferred from a shared address, not stated in the registry. - Clinicians at this address
- 160
Additional practice sites
- 1555 Soquel Dr, Santa Cruz, CA
Registry record
- Primary taxonomy
- Emergency Medicine Physician
207P00000X
- Also registered as
- Emergency Medicine Physician
- Licence states on file
- CA, FL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-10-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida