MATTHEW ALEXANDER WALLACE (NPI# 1427321041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427321041 |
| Entity Type | Individual |
| Full Name | MATTHEW ALEXANDER WALLACE |
| Credential | P.A. |
| Practice Address |
7497 Bernard Dr Temperance MI 48182-1552 |
| Practice Telephone | 6163189649 |
| Mailing Telephone | 6163189649 |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841746096 | Matthew Wallace | Pharmacist | 3200 St. Paul St, Baltimore, MD 21218 | 2016-08-28 |
| 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 |
| 1255867784 | Matthew Malone Wallace | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298 | 2017-05-03 |
| 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 |
7497 BERNARD DR |
| City | TEMPERANCE |
| State | MI |
| Zip Code | 48182-1552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982186771 | Ruben J Loo | Physical Therapist | 2000 W. Dean Road, Temperance, MI 48182 | 2018-08-29 |
| 1356881460 | Chelsea Engler | Licensed Practical Nurse | 22230 Camille, Temperance, MI 48182 | 2017-03-08 |
| 1801252291 | Charles Dean Tabbert | Nurse Anesthetist, Certified Registered | 3661 Saint Anthony Rd, Temperance, MI 48182 | 2016-01-14 |
| 1023360229 | Tamara Ruth Ciha | Technician, Other | 1070 North Park Dr, Temperance, MI 48182 | 2012-10-11 |
| 1356651004 | Meghanne Denise Decant | Registered Nurse | 2128 W Rauch Rd, Temperance, MI 48182 | 2010-10-15 |
| 1639325202 | Joanne Marie Segura | Licensed Practical Nurse | 6711 Summerfield, Temperance, MI 48182 | 2008-08-14 |
| 1952564775 | Kaye Cecelia Shepherd | Home Health Aide | 3346 St Anthony Road, Temperance, MI 48182 | 2008-07-02 |
| 1467638494 | Aspen Ridge, LLC | Skilled Nursing Facility | 951 Hickory Creek Blvd., Temperance, MI 48182 | 2008-01-22 |
| 1144406703 | Liberty Compounding Pharmacy, LLC | Pharmacy | 7355 Lewis Ave, Suite D, Temperance, MI 48182 | 2008-01-14 |
| 1760698724 | Rebecca Ann Pasko | Counselor | 9035 Lewis Ave, Temperance, MI 48182 | 2007-05-15 |
| Find all providers in zip 48182 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407871262 | Nicholas Richard Wilson | Physician Assistant | 8765 Lewis Ave, Temperance, MI 48182-9583 | 2006-07-13 |
| 1912956103 | Edward Charles Follas | Physician Assistant | 8765 Lewis Ave, Temperance, MI 48182-9583 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
| City | TEMPERANCE |
| Zip Code | 48182 |
Please comment or provide details below to improve the information on MATTHEW ALEXANDER WALLACE.
| 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.