| Doctor Name: | DR. AMBER ANN WALLACE |
| NPI Number: | 1104035526 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 01063765A |
| Business Practice Address: | 1686 Skylyn Dr Suite 101 Spartanburg, SC - 293071079 |
| Business Phone Number: | 8645603456 |
| Business Fax Number: | |
| Mailing Address: | 1686 Skylyn Dr, Suite 101 SPARTANBURG |
| State: | SC |
| Postal Code: | 293071079 |
| Phone Number: | 8645603456 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 03/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 01063765A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |