NPI 1003241571

Micah Jordan Wallace, PHARMD

Practitioner Pharmacist Charleston, SC

Practice location

Address: 2152 Savannah Hwy, Charleston, SC 29414-5311
Phone: (843) 556-8974

Registered specialties (2)

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 14060 (SC)

Other Pharmacist providers in South Carolina →

Pharmacist

Pharmacy Service Providers Taxonomy 183500000X Licence 36630 (TN)

Registry record

NPI: 1003241571
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Sep 2013
Record last updated: 3 Sep 2013

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.