DR. WILLIAM FREDRICK WALLACE (NPI# 1700920154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700920154 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM FREDRICK WALLACE |
| Credential | M.D. |
| Practice Address |
11700 Mercy Blvd Building 6 Savannah GA 31419-1753 |
| Mailing Address |
11700 Mercy Blvd Blvd 6 Savannah GA 31419-1753 |
| Practice Telephone | 9129273434 |
| Mailing Telephone | 9129273434 |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2012-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
060513 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE RAILROAD | 1700920154 | 01 |
| GA | 581114452A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518500834 | William J Wallace Jr. | Chiropractor | 22415 Market St Apt 1406, Cornelius, NC 28031-3028 | 2019-10-18 |
| 1851740609 | William Robert Wallace | Internal Medicine | 20828 W Deer Ridge Dr, Warrenton, MO 63383-6548 | 2016-06-11 |
| 1093143745 | William Dean Wallace | Pathology | 747 W 4170 S, Murray, UT 84123-1364 | 2013-10-16 |
| 1255765194 | William Wallace | Counselor | 318 S Oak, California, MO 65018 | 2013-08-28 |
| 1598028474 | William Todd Wallace | Physical Therapist | 8225 Coyote Trl, Texarkana, TX 75503-9657 | 2012-06-16 |
| 1184842627 | William Arthur Wallace Jr. | Surgery | 1679 Eagle Harbor Pkwy, Suite C, Fleming Island, FL 32003-4815 | 2007-04-22 |
| 1013087121 | William R Wallace | Chiropractor | 139 Morristown Rd, Bernardsville, NJ 07924-2606 | 2006-11-08 |
| 1508880493 | William C Wallace | Physical Therapist | 1113 N Castle Heights Ave, Suite D, Lebanon, TN 37087-5640 | 2006-07-26 |
| 1437184017 | William H. Wallace | Legal Medicine | 1421 N State St # St.1, Ste. 504, Jackson, MS 39202-1658 | 2006-07-11 |
| 1225087562 | William E Wallace | Surgery | 2000 Ben Merritt Dr, Suite B, Decatur, TX 76234-3848 | 2006-05-06 |
| Street Address |
11700 MERCY BLVD BUILDING 6 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215932066 | Cynthia Drown | Nurse Practitioner | 11700 Mercy Blvd, Plaza D Suite A, Savannah, GA 31419-1753 | 2005-06-17 |
| 1093205957 | Clint R. Fenton | Physician Assistant | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2018-05-16 |
| 1568962967 | Ortho Sport & Spine Physicians Savannah | Clinic/Center | 11700 Mercy Blvd, Savannah, GA 31419-1753 | 2018-02-13 |
| 1982134003 | Mackenzie Grace Shelton | Physician Assistant | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2017-06-13 |
| 1205383130 | Beverly J Lippert | Nurse Practitioner | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2016-09-08 |
| 1487000519 | Angel Everidge | Physician Assistant | 11700 Mercy Blvd, Plaza D, #6, Savannah, GA 31419 | 2016-05-07 |
| 1629470273 | Ortho Sport & Spine Physicians Savannah | Orthopaedic Surgery | 11700 Mercy Blvd, Savannah, GA 31419-1753 | 2014-09-25 |
| 1568805505 | Andrew Robert Papoy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11700 Mercy Blvd, Plaza D Bldg. 1 Suite A, Savannah, GA 31419 | 2013-04-09 |
| 1750635579 | St. Joseph's Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11700 Mercy Blvd, Plaza D Suite A, Savannah, GA 31419 | 2012-10-31 |
| 1407119423 | Rebecca M Hart | Nurse Practitioner | 11700 Mercy Blvd, Bldg #5, Savannah, GA 31419-1753 | 2012-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932653 | Loving Hands Adult Care | Home Health Aide | 101 St. Goerge Blvd, 6t, Savannah, GA 31419 | 2020-11-03 |
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1699318139 | Jessica Kaitlyn Matthewson | Nurse Practitioner | 11700 Mercy Blvd Plaza D, Bldg #5, Savannah, GA 31419 | 2019-10-28 |
| 1679133219 | Rebecca Denise Brown-tuyishimire | Counselor | Savannah Outpatient Clinic, 1170 Shawnee Street, Savannah, GA 31419 | 2019-06-17 |
| 1356900856 | Julio Roberto Castellanos Jr. | Behavior Technician | 785 King George Blvd Ste 103, Savannah, GA 31419 | 2019-06-07 |
| 1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
| 1326538521 | Jay Carter Jr. | Social Worker | 1170 Shawnee St., Savannah, GA 31419 | 2018-05-14 |
| 1245771070 | Emily Robertson | Nurse Practitioner | 11133 Abercorm Street, Suite 10, Savannah, GA 31419 | 2017-03-13 |
| 1760833750 | Cady-jo Steidle | Behavioral Analyst | 143 Sugar Mill Cir, Savannah, GA 31419 | 2016-06-30 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| Find all providers in zip 31419 | ||||
| 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 |
|---|---|---|---|---|
| 1093788192 | John Dale Rathbun | Internal Medicine | 11700 Mercy Blvd, Plaza D, Savannah, GA 31419-1753 | 2006-02-09 |
| 1114990678 | Gary Elkin | Internal Medicine | 11700 Mercy Blvd, Plaza D, Savannah, GA 31419-1753 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669019394 | Champ Vascular, LLC | Internal Medicine | 1825 Highway 34 E Ste 3400, Newnan, GA 30265-6423 | 2019-12-02 |
| 1174006159 | Kendall M Griffith Md LLC | Internal Medicine | 1497 Fair Rd Ste 311, Statesboro, GA 30458-0828 | 2018-09-14 |
| 1558869826 | Coordinated Health of Ga, LLC | Internal Medicine | 10 Glenlake Pkwy Ste 130c, Atlanta, GA 30328-3495 | 2018-01-31 |
| 1447559604 | David Brendan Casey | Internal Medicine | 1700 Tree Ln Ste 100, Snellville, GA 30078-6749 | 2011-03-26 |
| 1730404120 | Deepali Nivas Tukaye | Internal Medicine | 1505 Northside Blvd Ste 3400, Cumming, GA 30041-8223 | 2010-03-29 |
| 1659560647 | Oduwole Organization Inc | Internal Medicine | 1415 Highway 85 N Ste 310-296, Fayetteville, GA 30214-7738 | 2007-10-16 |
| 1053487462 | Tiftarea Cardiology | Internal Medicine | 907 E. 18th St, Ste 100, Tifton, GA 31794 | 2006-11-28 |
| 1255412094 | Jeetendra B Patel | Internal Medicine | 1301 Sigman Rd Ne Ste 200, Conyers, GA 30012 | 2006-10-18 |
| 1811082605 | Cardiac Disease Specialists, PC | Internal Medicine | 296 Merchants Sq, Dallas, GA 30132-5029 | 2006-10-04 |
| 1770508756 | Hunt Dandridge Anderson | Internal Medicine | 4500 Hospital Blvd, Suite 230, Roswell, GA 30076-0003 | 2006-07-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. WILLIAM FREDRICK 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.