Provider Demographics
NPI:1376035881
Name:WALLACE, ERIKA R (MD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:R
Last Name:WALLACE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:83 HERRICK ST STE 2004
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2757
Mailing Address - Country:US
Mailing Address - Phone:978-927-4800
Mailing Address - Fax:978-777-4792
Practice Address - Street 1:83 HERRICK ST STE 2004
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2757
Practice Address - Country:US
Practice Address - Phone:978-927-4800
Practice Address - Fax:978-777-4792
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2023-11-19
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Provider Licenses
StateLicense IDTaxonomies
MA275744207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology