DR. ERIC L WALLACE (NPI# 1568658243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568658243 |
Entity Type | Individual |
Full Name | DR. ERIC L WALLACE |
Credential | D.O. |
Practice Address |
700 W Ironwood Dr 320 Coeur D Alene ID 83814-2656 |
Practice Telephone | 2086255250 |
Mailing Telephone | 2086255250 |
Enumeration Date | 2007-09-17 |
Last Update Date | 2015-12-31 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | 03263 | KY | Allopathic & Osteopathic Physicians |
N | 207R00000X | Internal Medicine | 2007-014326 | NC | Allopathic & Osteopathic Physicians |
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
O0839 | ID | Allopathic & Osteopathic Physicians |
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
OP60505950 | WA | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417183476 | Eric T Wallace | Physical Therapist | W5361 County Road Kk Ste E, Appleton, WI 54915-7271 | 2009-06-04 |
1922218809 | Eric Wallace | Radiologic Technologist | 4004 Landside Dr, Louisville, KY 40220-3020 | 2007-05-22 |
1871706960 | Eric Wallace | Emergency Medicine | Paula Bldg 230, 728 Richard Arrington Blvd, Birmingham, AL 35294-0001 | 2007-05-07 |
1174665277 | Eric H Wallace | Dentist | 28 Se 6th St, Boca Raton, FL 33432-6016 | 2007-02-13 |
1780614529 | Eric L. Wallace | Surgery | 1450 Matthews Township Parkway, Suite 300, Matthews, NC 28105 | 2006-07-04 |
1912409160 | Eric Wallace | Psychologist | 22001 Fairmount Blvd, Shaker Heights, OH 44118-4819 | 2018-03-05 |
1528333838 | Eric Joseph Wallace Jr. | Radiology | 1542 Tulane Ave, Room 353, New Orleans, LA 70112-2865 | 2012-03-20 |
1891838991 | Eric Michael Wallace | Dentist | 1515 State St, Suite 9, Santa Barbara, CA 93101-2536 | 2007-02-15 |
1154434488 | Eric Wallace | Family Medicine | 143 Longwater Dr, Norwell, MA 02061-1683 | 2006-08-17 |
1578502191 | Eric Wallace | Radiology | 168 N Brent St, Suite 402, Ventura, CA 93003-2817 | 2006-06-06 |
Street Address |
700 W IRONWOOD DR 320 |
City | COEUR D ALENE |
State | ID |
Zip Code | 83814-2656 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699771451 | Ronald J Stout | Otolaryngology | 700 W Ironwood Dr, Ste 236, Coeur D Alene, ID 83814-4484 | 2005-06-24 |
1033635180 | Jamie Lee Park | Pharmacist | 700 W Ironwood Dr, Coeur D Alene, ID 83814-2656 | 2017-08-21 |
1063944726 | Mandi Nordhagen | Pharmacist | 700 W Ironwood Dr, Suite 228, Coeur D Alene, ID 83814-2656 | 2017-03-31 |
1679004675 | Jamie Cervi-skinner | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-22 |
1982144424 | Carissa Hober | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-02 |
1861939910 | Kellie Kathryn Breaux | Nurse Practitioner | 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 | 2017-01-27 |
1902348709 | Michael Watrobka | Physician Assistant | 700 W Ironwood Dr, Suite 120e, Coeur D Alene, ID 83814-2656 | 2016-11-09 |
1841748530 | Elizabeth St John | Physician Assistant | 700 W Ironwood Dr, Ste 341, Coeur D Alene, ID 83814-2656 | 2016-09-12 |
1184076465 | Craig Allred | Audiologist | 700 W Ironwood Dr, Ste 278, Coeur D Alene, ID 83814-2656 | 2016-07-11 |
1962869008 | Natalie Jeane Bartell | Nurse Practitioner | 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 | 2016-01-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
Find all providers in zip 83814 |
Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
1730688748 | Cardiac Cin of Boise LLC | Internal Medicine | 800 W Main St Ste 1460-10, Boise, ID 83702-5945 | 2018-02-05 |
1144544644 | Jeffrey J Heslop | Internal Medicine | 6140 W Curtsian, Ste 200, Boise, ID 83704 | 2010-03-26 |
1063674505 | Joseph Aloysius Walsh IIi | Internal Medicine | 6140 W Curtisian Ave Ste 100, Boise, ID 83704 | 2008-06-26 |
1093972564 | St Patrick Hosp and Health Sci Ctr | Internal Medicine | 203 S. Daisy St, Salmon, ID 83467-4343 | 2008-05-21 |
1932153137 | Charles E Eiriksson Jr. | Internal Medicine | 300 E Jeffreson, Ste 101, Boise, ID 83712 | 2006-05-20 |
1346713302 | Radial First Holdings | Internal Medicine | 2001 S Woodruff Ave Ste 12b, Idaho Falls, ID 83404-6372 | 2019-01-02 |
1730563909 | Radial First Cardiovascular Associates, LLC | Internal Medicine | 2001 S Woodruff Ave, Suite 3, Idaho Falls, ID 83404-6371 | 2015-07-16 |
1952670523 | Teton Cardiology PC | Internal Medicine | 3200 Channing Way, Ste A201, Idaho Falls, ID 83404-7546 | 2011-12-27 |
1902197866 | Robert Wynn Tonks | Internal Medicine | 775 Pole Line Rd W Ste 112, Twin Falls, ID 83301-5819 | 2011-04-27 |
Find all providers with the same taxonomy |
City | COEUR D ALENE |
Zip Code | 83814 |
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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.