NPI 1205804945

Wallace Clements Tarry, MD

Practitioner Vascular Surgery Physician Mooresville, NC

Practice location

Address: 146 Medical Park Rd STE 206, Mooresville, NC 28117-8528
Phone: (704) 799-3939
Mailing address: PO Box 19305, Charlotte, NC 28219-9305

Registered specialties (2)

Vascular Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2086S0129X Licence 200200613 (NC)

Other Surgery providers in North Carolina →

Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 200200613 (NC)

Registry record

NPI: 1205804945
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Mar 2006
Record last updated: 16 Jul 2024

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.