Most Relevant Information
Provider Data
| NPI Number: | 1003255605 |
| Provider Name: | SARA SHEEHAN WALLACE MD |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | LL35809 |
Most Important Dates
| Enumeration Date: | 06/18/2013 |
| Last Updated: | 12/14/2020 |
Provider Practice Location
3240 SUNSET BLVD
WEST COLUMBIA
SC
291693428
Practice Location Phone/Fax
| Phone: | 8033598855 |
| Fax: | 8037946480 |
Provider Mailing Location
PO BOX 6069
WEST COLUMBIA
SC
291716069
Provider Mailing Phone/Fax
| Phone: | 8033598855 |
| Fax: | 8037946480 |
Suggested EMR
Pediatrics EMR