| Shannon R Wallace, PA-C | |
|
5818 D Harbour View Blvd, Suite 150, Suffolk, VA 23435-3327 | |
| (757) 215-1400 | |
| (757) 215-1403 |
| Full Name | Shannon R Wallace |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 5818 D Harbour View Blvd, Suffolk, Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598103111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0110004256 (Virginia) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon R Wallace, PA-C 5818 D Harbour View Blvd, Suite 150, Suffolk, VA 23435-3327 Ph: (757) 215-1400 | Shannon R Wallace, PA-C 5818 D Harbour View Blvd, Suite 150, Suffolk, VA 23435-3327 Ph: (757) 215-1400 |
Miss April Channing Lust, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 4868 Bridge Rd Ste 300, Suffolk, VA 23435 Phone: 757-483-7100 Fax: 615-320-3259 | |
Ms. Lindsey Marie Williams, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2050 Hillpoint Blvd N, Suffolk, VA 23434 Phone: 757-934-3434 Fax: 757-538-9038 | |
Aksel Keklik, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 150 Burnetts Way, Ste. 100, Suffolk, VA 23434 Phone: 757-547-5145 Fax: 757-539-7488 | |
Erik Jon Richardson, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2790 Godwin Blvd Ste 101, Suffolk, VA 23434 Phone: 757-539-0670 | |
Victoria Fortin, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3910 Bridge Rd Unit 101, Suffolk, VA 23435 Phone: 757-942-2566 | |
Jenny Whittington, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5108 Wing Foot Ct, Suffolk, VA 23435 Phone: 757-679-2939 | |
Kelsey Bridget Mahoney Sayre, Physician Assistant Medicare: Medicare Enrolled Practice Location: 2000 Meade Pkwy Ste 100, Suffolk, VA 23434 Phone: 757-934-9395 |