Michael Anthony Wallace, IDC is an independent duty corpsman military health care provider in Portsmouth, VA. The provider is a Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. Michael Anthony Wallace, IDC NPI is 1427216837. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA
ZIP 23708-111
Phone: (757) 953-6505
The enumeration date for this NPI number is 6/2/2008 and was last updated on 6/23/2011.