IndividualActive
Matthew Wallace, M.D.
NPI 1255867784 · MOHS-Micrographic Surgery Physician · Richmond, VA
Provider details
- NPI number
- 1255867784
- Entity type
- Individual
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 0101274476 (VA)
Mailing address
3829 Gaskins Rd Ste a
Richmond, VA 23233-1437
Registry dates
- Enumerated
- 2017-05-03
- Last updated
- 2025-09-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.