MR. GREGORY HALL WALLACE (NPI# 1346284957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346284957 |
| Entity Type | Individual |
| Full Name | MR. GREGORY HALL WALLACE |
| Credential | DO |
| Practice Address |
4623 Wesley Ave Bmf Pediatric Care Suite G Norwood OH 45212 |
| Mailing Address |
Po Box 640220 Cincinnati OH 45264-0220 |
| Practice Telephone | 5136313338 |
| Practice Fax Number | 5136313385 |
| Mailing Telephone | 5132818000 |
| Mailing Fax Number | 5132815221 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 34008036W | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2442986 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902092 | Gregory Stephen Wallace | Family Medicine | 1042 Mason Woods Dr Ne, Atlanta, GA 30329-3802 | 2018-12-05 |
| 1073902250 | Gregory Roy Wallace | Rehabilitation Practitioner | 14545 Sherman Cir, Van Nuys, CA 91405-3087 | 2015-01-12 |
| 1558701250 | Gregory Wallace | Family Medicine | 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2013-06-27 |
| 1770712309 | Gregory L. Wallace | Anesthesiology | 204 Mccollum Dr, Suite 101, Laramie, WY 82070-5151 | 2009-07-02 |
| 1992915532 | Gregory Wallace | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2007-05-23 |
| 1700898012 | Gregory Wallace | Social Worker | 6123 Montrose Rd, Rockville, MD 20852 | 2006-08-13 |
| Street Address |
4623 WESLEY AVE BMF PEDIATRIC CARE SUITE G |
| City | NORWOOD |
| State | OH |
| Zip Code | 45212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013568930 | Kelly Diane Weber | Social Worker | Va Behavioral Health and Wellness Center, 4600 Smith Road, Norwood, OH 45212 | 2019-09-23 |
| 1629566039 | Jessica Lee Eckstein | Nurse Practitioner | 4805 Montgomery Rd Ste 154, Cincinnati, OH 45212 | 2018-05-01 |
| 1578092847 | Kerry Ellen Ragland | Counselor | 2300 Wall Street, Cincinnati, OH 45212 | 2017-06-08 |
| 1912256454 | Helen Virginia Blackshire | Occupational Therapy Assistant | 4750 Wesley Avenue Suite J, Cincinnati, OH 45212 | 2012-08-30 |
| 1902154933 | Shelby Davis Lewis | Social Worker | 4750 Wesley Avenue, Suite J, Cincinnati, OH 45212 | 2012-08-23 |
| 1366727133 | Kelly Gray | Pharmacist | 4605 Montgomery Road, Norwood, OH 45212 | 2011-10-12 |
| 1588981351 | Stephen M Zitelli | Family Medicine | 1775 Lexington Ave, Cincinnati, OH 45212 | 2010-05-03 |
| 1699952416 | David William Barr | Marriage & Family Therapist | 4301 Smith Road, Cincinnati, OH 45212 | 2008-01-23 |
| 1780704718 | Douglas A Dix | Dentist | 5451 Montgomery Road, Cincinnati, OH 45212 | 2007-03-31 |
| 1376615104 | Orthopedic Diagnostic & Treatment Ctr Inc | Orthopaedic Surgery | 4600 Smith Road, Suite B, Norwood, OH 45212 | 2006-11-15 |
| Find all providers in zip 45212 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215375860 | Jenna M O'connell | Pediatrics | 1177 Providence Hwy, Norwood, MA 02062 | 2013-06-05 |
| 1558523019 | Eric Tjonahen | Pediatrics | 62 Walpole Street, Norwood, MA 02062 | 2008-06-26 |
| 1316910979 | Evan David Finkelstein | Pediatrics | 62 Walpole St, Norwood, MA 02062-3316 | 2006-02-13 |
| 1881664043 | Diane K Silverman | Pediatrics | 1177 Providence Highway - Route 1, Norwood, MA 02062 | 2006-01-23 |
| 1497741946 | Michael A Lee | Pediatrics | 325 River Ridege Drive, Norwood, MA 02062 | 2005-09-21 |
| 1548268956 | Lilia A. Cuozzo | Pediatrics | 1177 Providence Highway, Norwood, MA 02062 | 2005-07-09 |
| 1730187212 | Jonathan L Caine | Pediatrics | 100 Morse St, 2nd Floor West, Norwood, MA 02062-4679 | 2005-07-08 |
| 1407852031 | Lowell E Fox | Pediatrics | 325 River Ridge Dr, Norwood, MA 02062-5027 | 2005-06-28 |
| 1407331853 | Rebecca Lynn Reed | Pediatrics | 1177 Providence Highway, Norwood, MA 02062 | 2018-10-02 |
| 1083898753 | Rachel N Agrin-silva | Pediatrics | 325 River Ridge Dr, Dedham Medical Associates - Pediatrics, Norwood, MA 02062-5027 | 2007-12-18 |
| Find all providers in NORWOOD | ||||
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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.