DR. MICHAEL H WALLACE (NPI# 1801982475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801982475 |
Entity Type | Individual |
Full Name | DR. MICHAEL H WALLACE |
Credential | M.D. |
Practice Address |
269 N 1st Ave Suite 102 Iowa City IA 52245-3616 |
Practice Telephone | 3196887777 |
Practice Fax Number | 3196887775 |
Mailing Telephone | 3196887777 |
Mailing Fax Number | 3196887775 |
Enumeration Date | 2006-10-04 |
Last Update Date | 2011-10-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 37120 | IA | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417014424 | Michael J Wallace | Dentist | 1600 E 19th St, Suite 301, Edmond, OK 73013-6622 | 2007-01-02 |
1518042696 | Michael J. Wallace | Dentist | 1263 High St, Auburn, CA 95603-5016 | 2006-10-26 |
1124127279 | Michael James Wallace | Dentist | 1195 W Mason St, Green Bay, WI 54303-2045 | 2006-09-22 |
1679585038 | Michael Patrick Wallace | Dentist | 9225 Manchester Rd, Suite 101, Saint Louis, MO 63144-2640 | 2006-08-13 |
1467438937 | Michael Lloyd Wallace | Pathology | 522 Alpha Dr, Pittsburgh, PA 15238-2912 | 2005-12-16 |
1609356864 | Michael Wallace | Physical Therapy Assistant | 5455 Knickerbocker Rd, San Angelo, TX 76904-7711 | 2018-08-17 |
1225579899 | Michael Wallace | Counselor | 500 Allerton St, Second Floor, Redwood City, CA 94063-1519 | 2017-03-16 |
1376922948 | Michael Taylor Wallace | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38103 | 2015-05-28 |
1194029777 | Michael T Wallace | Nurse Practitioner | 9900 Bren Rd E, Minnetonka, MN 55343-9664 | 2010-12-22 |
1003116658 | Michael Eugene Wallace | Psychologist | 201 E Liberty St, Suite 2, Ann Arbor, MI 48104-2118 | 2010-10-29 |
Street Address |
269 N 1ST AVE SUITE 102 |
City | IOWA CITY |
State | IA |
Zip Code | 52245-3616 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962480970 | Susan Dale Wall | Dermatology | 269 N 1st Ave, Ste 100, Iowa City, IA 52245 | 2006-01-09 |
1376064154 | Susan Ann Meyer | Nurse Practitioner | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2017-06-30 |
1669916102 | Jennifer Cecil Sassman | Nurse Practitioner | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2016-12-16 |
1679925069 | Courtney Leigh Henn Engel | Physician Assistant | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2016-07-08 |
1477806354 | Ic Dermatology, PC | Dermatology | 269 N 1st Ave, Ste 100, Iowa City, IA 52245-3616 | 2012-10-17 |
1467747782 | Dacia N Watts | Registered Nurse | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2011-06-15 |
1952549792 | Ic Dermatology PC | Dermatology | 269 N 1st Ave, Suite 100, Iowa City, IA 52245-3616 | 2009-02-02 |
1225152374 | Erica Suzanne Colleran | Dermatology | 269 N 1st Ave, Suite 100, Iowa City, IA 52245-3616 | 2007-03-16 |
1801933569 | Mercy Services Iowa City, Inc. | Clinic/Center | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2007-01-31 |
1013097856 | Dustaff R.c. Persaud | Physician Assistant | 269 N 1st Ave, Iowa City, IA 52245-3616 | 2006-10-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730699356 | Mary Beth Shapcott | Registered Nurse | 500 East Market St., Mercy Hospital Diabetes Education, Iowa City, IA 52245 | 2017-10-10 |
1366703167 | Elizabeth Bright | Occupational Therapist | 540 E. Jefferson Street., Ste.302, Iowa City, IA 52245 | 2012-06-07 |
1043518368 | Robert Brian Goffstein | Ophthalmology | 403 North 7th Ave, Iowa City, IA 52245 | 2011-03-10 |
1750682936 | Robert Alvin Blair | Dentist | 134 Broadmoor Lane, Iowa City, IA 52245 | 2010-11-04 |
1215167457 | Laura J Ericson | Occupational Therapist | 540 E Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-07-22 |
1780818294 | Kathryn Leigh Bossen | Physical Therapist | 540 E. Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-05-12 |
1073751095 | Jessica L Keeran | Physical Therapist | 2751 Northgate Dr. Ne, Iowa City, IA 52245 | 2009-01-29 |
1437330370 | Francine Mardarello Hunnicutt | Marriage & Family Therapist | 1610 East College St, Iowa City, IA 52245 | 2007-11-20 |
1659574853 | Joan Victoria Rinner | Marriage & Family Therapist | 121 University Services Building, University of Iowa, Iowa City, IA 52245 | 2007-06-06 |
1053529966 | Steve Bernt Hammerstrom | Chiropractor | 373 B Scott Court, Iowa City, IA 52245 | 2007-05-21 |
Find all providers in zip 52245 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972162519 | Stephanie Anne Pickthorn | Family Medicine | 200 Hawkins Dr Dept Family, Iowa City, IA 52242-1009 | 2019-06-07 |
1326527284 | Ramy Salib | Family Medicine | 1000 Oakcrest St, Iowa City, IA 52246-5194 | 2018-08-11 |
1932685013 | Christian Ann Mann | Family Medicine | 826 Basswood Ln, Iowa City, IA 52246-5810 | 2018-07-12 |
1255760260 | Mintesinot Fitamo | Family Medicine | 825 Oakcrest St Apt 6, Iowa City, IA 52246-3421 | 2013-11-11 |
1548526189 | State University of Iowa | Family Medicine | 767 Mormon Trek Blvd, Iowa City, IA 52246-1812 | 2012-04-09 |
1336410471 | Catherine Dehaven Swanson | Family Medicine | 1717 Winston Dr, Iowa City, IA 52245-6047 | 2012-01-20 |
1881978047 | Bradley Center PC | Family Medicine | 1527 S Gilbert St, Iowa City, IA 52240-4367 | 2011-10-06 |
1205159688 | Mei Shi | Family Medicine | 1067 Ryan Ct, Iowa City, IA 52246-2847 | 2010-03-12 |
1013241850 | State University of Iowa | Family Medicine | 1632 Sycamore St, Iowa City, IA 52240-6044 | 2009-09-28 |
1972720274 | Cecilia M Redmond-norris | Family Medicine | 2440 Towncrest Dr, Iowa City, IA 52240-6622 | 2007-04-19 |
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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.