Provider Demographics
NPI:1740457209
Name:WALLACE, AMY HOOKS (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:HOOKS
Last Name:WALLACE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 75216
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-0216
Mailing Address - Country:US
Mailing Address - Phone:336-277-8800
Mailing Address - Fax:
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-277-8800
Practice Address - Fax:336-277-8850
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2022-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2012-00695207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology