IndividualActive
Alexander Wallace
NPI 1083364772 · Registered Nurse · Martinsburg, WV
Provider details
- NPI number
- 1083364772
- Entity type
- Individual
- Primary specialty
- Registered NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 107631 (WV)
Mailing address
208 Old Mill Rd
Martinsburg, WV 25401-9219
Registry dates
- Enumerated
- 2022-03-25
- Last updated
- 2022-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.