KIMBERLY WALLACE MD PC


Address: 12900 W 9 Mile Road, Oak Park, MI 48237
Phone: 2485479292

KIMBERLY WALLACE MD PC (NPI# 1497397202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497397202
Entity Type Organization
Organization Name KIMBERLY WALLACE MD PC
Practice Address 12900 W 9 Mile Road
Oak Park
MI 48237
Mailing Address P.o. Box 700263
Plymouth
MI 48170
Practice Telephone 2485479292
Enumeration Date 2019-10-14
Last Update Date 2019-11-13
Authorized Official Name KIMBERLY WALLACE (PRESIDENT)
Authorized Official Telephone 2485479292
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
Ambulatory Health Care Facilities

Office Location

Street Address 12900 W 9 MILE ROAD
City OAK PARK
State MI
Zip Code 48237

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699395459 Kroger Co of Michigan Durable Medical Equipment & Medical Supplies 25940 Greenfield Rd, Oak Park, MI 48237 2020-04-22
1174009211 Jo-anne Spencer Woodard Social Worker 23300 Greenfield, Suite 122, Oak Park, MI 48237 2018-07-12
1285163600 Yolanda Alicia Winters-byrdo Social Worker 18712 Quarry Rd., Riverview, MI 48237 2017-06-08
1972059699 Cynthia F Lewis Technician, Other 15251 Kenwood St., Oak Park, MI 48237 2016-09-01
1083039531 Tema Pefok Home Health Aide 21930 Harding St, Oak Park, MI 48237 2014-02-20
1073937116 A1 Home Help Services Home Health 21700 Green Field Road, 253, Oak Park, MI 48237 2014-02-10
1629346648 Mitun Chablani Physical Therapist 25900 Greenfield Rd Ste 110, Oak Park, MI 48237 2011-12-05
1841575891 Hazy Mindful Care Giving Agency Inc Hospice Care, Community Based 21700 Greenfield, Ste 264, Oakpark, MI 48237 2011-10-20
1710101688 Andrew Hardy Jr. Internal Medicine 22100 Greenfield Road, Oak Park, MI 48237 2007-04-12
1699801746 Rachel N Freedland Social Worker 26000 Stratford Pl, Oak Park, MI 48237 2007-02-25
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336681568 Artemis for Women Clinic/Center 615 Woodbine Ave, Oak Park, IL 60302-1607 2016-11-04
1558579243 Affiliates In Diseases & Surgery of The Skin, S.c. Clinic/Center 1050 Chicago Avenue, Oak Park, IL 60302 2007-05-18
1669731592 Artemis, LLC Clinic/Center 137 N Oak Park Ave, Suite 129, Oak Park, IL 60301-1344 2012-05-12
1417148685 Rejuvenetics, Ltd Clinic/Center 137 N Oak Park Ave, Ste 208, Oak Park, IL 60301-1344 2007-08-05

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1629684386 True Women's Clinic of Grand Rapids, PC Clinic/Center 2144 E Paris Ave Se Ste 230, Grand Rapids, MI 49546-6111 2020-09-18
1265081418 Cherry Street Services Inc Clinic/Center 2125 Wrenwood St Sw Ofc Therapist, Wyoming, MI 49519-2362 2019-09-10
1023662079 J & D Vision Inc Clinic/Center 41821 Garfield Rd, Clinton Twp, MI 48038-1965 2019-07-29
1649839945 Michigan Institute of Sleep Disorders Pllc Clinic/Center 7108 Autumn Hill Dr, West Bloomfield, MI 48323-3904 2019-06-10
1447715131 Ryan Klanseck, Do Clinic/Center 16986 Robbins Rd Ste 140, Grand Haven, MI 49417-2795 2019-02-06
1598242455 Gratiot Advanced Center LLC Clinic/Center 7612 Gratiot Ave Ste 200, Detroit, MI 48213-2822 2018-07-24
1902356140 Midmichigan Pain Clinic/Center 2305 Hawthorn Dr, Suite B, Mt Pleasant, MI 48858-1202 2016-10-12
1184085516 Hester S Pernell Md Pllc Clinic/Center 24628 Ridgeview Dr, Farmington Hills, MI 48336-1905 2016-03-12
1275937625 Innovative Anesthesia Services PC Clinic/Center 847 Parchment Dr Se Ste 105, Grand Rapids, MI 49546 2014-10-14
1538569439 Maple Healthcare Medical Center P.C. Clinic/Center 2442 E Maple Ave Ste 400, Flint, MI 48507-4462 2014-08-27
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Competitor

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City OAK PARK
Zip Code 48237

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Dataset Information

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.

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