DR. MATTHEW MALONE WALLACE (NPI# 1255867784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255867784 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW MALONE WALLACE |
| Credential | M.D. |
| Practice Address |
1250 E Marshall St Richmond VA 23298 |
| Mailing Address |
Po Box 980509 1250 E Marshall St Richmond VA 23298 |
| Practice Telephone | 8048289726 |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841746096 | Matthew Wallace | Pharmacist | 3200 St. Paul St, Baltimore, MD 21218 | 2016-08-28 |
| 1427321041 | Matthew Alexander Wallace | Physician Assistant | 7497 Bernard Dr, Temperance, MI 48182-1552 | 2012-02-13 |
| 1609012731 | Matthew Tristan Wallace | Orthopaedic Surgery | 701 Kingston Rd, Baltimore, MD 21212-1939 | 2008-12-19 |
| 1760426258 | Matthew Edwin Wallace | Specialist/Technologist | Creighton Uniuversity, 2500 California Plaza, Omaha, NE 68178-0001 | 2006-06-15 |
| 1356329114 | Matthew K Wallace | Orthopaedic Surgery | 212 E Central Ave Ste 140, Spokane, WA 99208-6289 | 2006-01-03 |
| 1881177806 | Matthew Evan Wallace | Nurse Practitioner | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2018-09-14 |
| 1841638897 | Matthew William Wallace | Emergency Medicine | 2815 South Seacrest Blvd, Gme Suite Lower Level B, Boynton Beach, FL 33435 | 2013-06-12 |
| 1861706145 | Matthew Seymour Wallace | Dentist | 63 Geiger Rd, Rome, NY 13441-4324 | 2010-07-29 |
| 1487679627 | Matthew Brevard Wallace IIi | Family Medicine | 1200 Sunset Ln Ste 2210, Culpeper, VA 22701-3376 | 2006-07-12 |
| 1790740074 | Matthew D Wallace | Physical Therapist | Hss Ancillary Services, PC, 85 College St, Hamilton, NY 13346 | 2006-04-19 |
| Street Address |
1250 E MARSHALL ST |
| City | RICHMOND |
| State | VA |
| Zip Code | 23298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265436158 | Elizabeth A Huntoon | Physical Medicine & Rehabilitation | 1250 E Marshall St, Physical Medicine and Rehab, Richmond, VA 23298-5051 | 2005-06-08 |
| 1700485943 | Jayme Holmes Kunkel | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-10-20 |
| 1508463068 | Benjamin Brickman Holt | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-10-07 |
| 1780298620 | Tara Lynne Taylor | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-09-08 |
| 1770197956 | Imane Chedid | Emergency Medicine | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-09-03 |
| 1659982338 | Randi Thompson | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-08-14 |
| 1619585684 | Chelsea Elise Snead | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-07-16 |
| 1285258095 | Trevor Harrison Nordin | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298-5051 | 2020-06-08 |
| 1912521972 | Ashton Jordan Engdahl | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298-5051 | 2020-06-04 |
| 1538783048 | Ann Forrest | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298-5051 | 2020-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730703604 | Russell Wayne Dowell | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Em Residency/fellowship, 1250 E. Marshall Street, Richmond, VA 23298 | 2020-06-05 |
| 1215551262 | Anna Leigh Cline | Student in an Organized Health Care Education/Training Program | Vcuhs Department of Emergency Medicine, 980401, 1250 E Marshall Street, Richmond, VA 23298 | 2020-06-05 |
| 1598389629 | Annabel Eujung Baek | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Plastic Surgery Residency, 980154, 1250 E. Marshall Street, Richmond, VA 23298 | 2020-06-04 |
| 1235752957 | Valerie Tammy Tran | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, 980509, 1250 E Marshall St, Richmond, VA 23298 | 2020-05-28 |
| 1386267193 | Michael Terribile | Student in an Organized Health Care Education/Training Program | Vcuhs Department of Pediatrics Residency, 980163, Richmond, VA 23298 | 2020-05-27 |
| 1417585449 | Ryan Louis Naum | Student in an Organized Health Care Education/Training Program | Vcuhs Dept. of Neurology Residency, #980599, 1250 E. Marshall Street, Richmond, VA 23298 | 2020-03-27 |
| 1477102531 | Shanon Fitzpatrick Beam | Nurse Practitioner | Vcu Medical Center, 1250 East Marshall Street, Richmond, VA 23298 | 2019-09-10 |
| 1922666924 | Sumerth Kumar Pathak | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Psychiatry, 980710, 1250 E. Marshall Street, Richmond, VA 23298 | 2019-06-04 |
| 1467010595 | Christopher Bednarz | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Surgery Residency, 980118, 1250 E. Marshall Street, Richmond, VA 23298 | 2019-06-04 |
| 1629636782 | Nicholet Mitchell | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Em Residency/fellowship, 980401, 1250 E. Marshall Street, Richmond, VA 23298 | 2019-06-04 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708666 | Candice Carriere | Student in an Organized Health Care Education/Training Program | 211 Terrace Creek Ct, Richmond, TX 77406-3590 | 2020-10-23 |
| 1548867500 | Daniel Bailey Jr. | Student in an Organized Health Care Education/Training Program | 6211 Gilchrist Ave, Richmond, VA 23231-4723 | 2020-10-02 |
| 1659987899 | Chinwe Nwakaego Dike | Student in an Organized Health Care Education/Training Program | 8023 Bueller Pass Ln, Richmond, TX 77407-1824 | 2020-09-22 |
| 1073127924 | Yuzuru Sambommatsu | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Transplant Surgery Fellowship, 980057, 1250 E. Marshall Street, Richmond, VA 23298-0057 | 2020-09-08 |
| 1639782949 | Vannarong Keo | Student in an Organized Health Care Education/Training Program | 805 Sam Christopher Ct, Richmond, KY 40475-3048 | 2020-08-26 |
| 1770100646 | Reva Jain | Student in an Organized Health Care Education/Training Program | 171 Reid Ln, Richmond, CA 94801-1711 | 2020-06-26 |
| 1477178077 | Robert Cole Schmidt | Student in an Organized Health Care Education/Training Program | Vcu Department of Orthopedics Residency, 980153, 1250 E Marshall St, Richmond, VA 23298-0153 | 2020-06-10 |
| 1144845900 | Alexandra Ernst | Student in an Organized Health Care Education/Training Program | 1250 E Marshal Street, Vcuhs Dept of Orth Residency 980153, Richmond, VA 23298-0153 | 2020-06-08 |
| 1346865136 | Virginia Hamilton Behlen Lucas | Student in an Organized Health Care Education/Training Program | 1201 Broad Rock Blvd Rm 1k, Richmond, VA 23249-0001 | 2020-06-08 |
| 1023632817 | Francis Jefferson Oser II | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Surg, 980645, 1250 E Marshall, Richmond, VA 23298-0645 | 2020-06-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.