IndividualActive
William Wallace, M.D.
NPI 1093143745 · Immunopathology Physician · Murray, UT
Provider details
- NPI number
- 1093143745
- Entity type
- Individual
- Primary specialty
- Immunopathology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 168418-1205 (UT)
Mailing address
747 W 4170 S
Murray, UT 84123-1364
Registry dates
- Enumerated
- 2013-10-16
- Last updated
- 2013-10-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.