IndividualActive
Richard Wallace, MD
NPI 1013957034 · Otology & Neurotology Physician · Charleston, WV
Provider details
- NPI number
- 1013957034
- Entity type
- Individual
- Primary specialty
- Otology & Neurotology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- WV11648 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone: (304) 343-4371
Fax: (304) 353-0215
Approximate (ZIP-level) locationGet directions
Mailing address
1306 Kanawha Blvd E
Charleston, WV 25301-3001
Registry dates
- Enumerated
- 2006-06-07
- Last updated
- 2012-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.