NPI 1154512424

John D Wallace Enterprises

Organisation Preferred Provider Organization New Bern, NC

Practice location

Address: 513 George St A, New Bern, NC 28560-4811
Phone: (252) 514-0330

Authorised official

Name: John David Wallace
Title: President
Phone: (252) 514-0330

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

Other Preferred Provider Organization providers in North Carolina →

Registry record

NPI: 1154512424
Entity type: Organization
NPI issued: 1 Aug 2007
Record last updated: 1 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.