DR. MATTHEW WILLIAM WALLACE (NPI# 1841638897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841638897 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW WILLIAM WALLACE |
| Credential | M.D. |
| Practice Address |
2815 South Seacrest Blvd Gme Suite Lower Level B Boynton Beach FL 33435 |
| Mailing Address |
2815 S Seacrest Blvd Gme Suite Lower Level B Boynton Beach FL 33435 |
| Practice Telephone | 5617377733 |
| Practice Fax Number | 5617330774 |
| Mailing Telephone | 5617377733 |
| Mailing Fax Number | 5617330774 |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2020-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | ME143324 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAL LICENSE | ME143324 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841746096 | Matthew Wallace | Pharmacist | 3200 St. Paul St, Baltimore, MD 21218 | 2016-08-28 |
| 1427321041 | Matthew Alexander Wallace | Physician Assistant | 7497 Bernard Dr, Temperance, MI 48182-1552 | 2012-02-13 |
| 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 |
| 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 |
2815 SOUTH SEACREST BLVD GME SUITE LOWER LEVEL B |
| City | BOYNTON BEACH |
| State | FL |
| Zip Code | 33435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861474819 | Pedro A Rabionet | Pathology | 2815 South Seacrest Blvd, Boynton Beach, FL 33435 | 2005-11-16 |
| 1639734619 | Charmaine Lorraine Dixon | Registered Nurse | 2815 South Seacrest Blvd, Boynton Beach, FL 33435 | 2019-05-06 |
| 1942223094 | Timothy Lee Thar | Radiology | 2815 South Seacrest Blvd, Boynton Beach, FL 33435 | 2006-07-26 |
| 1639152366 | Jose E Olivella | Pathology | 2815 South Seacrest Blvd, Boynton Beach, FL 33435 | 2005-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824186 | Sarah Gostich | Podiatrist | 2815 S Searest Blvd, Boynton Beach, FL 33435 | 2019-08-01 |
| 1104487768 | Amira Nabil Halim Ibrahim | Student in an Organized Health Care Education/Training Program | Florida Atlantic University Medicine-bethesda Hospital, 2623 S Seacrest Blvd, Boynton Beach, FL 33435 | 2019-06-25 |
| 1972064491 | Elizabeth Anita Calhoun | Emergency Medicine | Bethesda Hospital East, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-27 |
| 1164983086 | Thomas Rex Peterson | Emergency Medicine | Fau Emergency Medicine, Bethesda Hospital East, Attn: Joanne Daly, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-26 |
| 1033686068 | Valery L. Petit-homme | Behavior Technician | 515 Se 20th Ave, Apt 10a, Boynton Beach, FL 33435 | 2018-10-29 |
| 1104391648 | Summit Detox | Psychiatry & Neurology | 3330 S. Federal Highway, 3rd Floor, Boynton Beach, FL 33435 | 2018-10-11 |
| 1184120008 | Zachariah Hatoum | Student in an Organized Health Care Education/Training Program | 2815 South Seacrest Blvd., Gme Suite Lower Level B, Boynton Beach, FL 33435 | 2018-03-30 |
| 1922503135 | Anneka Mariesha Hutton | Student in an Organized Health Care Education/Training Program | 2623 South Seacrest Boulevard, Florida Atlantic University Medicine At Bethesda Hospit, Boynton Beach, FL 33435 | 2018-03-28 |
| 1477079473 | Benezon LLC | Case Management | 609 Manatee Bay Drive, Boynton Beach, FL 33435 | 2017-08-21 |
| 1750814091 | Maria Mijares | Student in an Organized Health Care Education/Training Program | 2623 South Seacrest Blvd., Suite 100, Fau Medicine At Bhe, Boynton Beach, FL 33435 | 2017-04-04 |
| Find all providers in zip 33435 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972064491 | Elizabeth Anita Calhoun | Emergency Medicine | Bethesda Hospital East, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-27 |
| 1164983086 | Thomas Rex Peterson | Emergency Medicine | Fau Emergency Medicine, Bethesda Hospital East, Attn: Joanne Daly, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-26 |
| 1841704038 | Sports Er & Urgent Care Center Inc | Emergency Medicine | 303 E Woolbright Rd Ste 252, Boynton Beach, FL 33435-6010 | 2017-11-27 |
| 1578814570 | Sterling Emergency Services of Florida Pa | Emergency Medicine | 9655 Boynton Beach Blvd, Boynton Beach, FL 33472-4421 | 2012-10-01 |
| 1003172628 | West Boynton Urgent Care, LLC | Emergency Medicine | 8230 S Jog Rd, Boynton Beach, FL 33472-2938 | 2012-04-09 |
| 1811289572 | Jean Dominique Morancy | Emergency Medicine | 4201 Renaissance Way, Boynton Beach, FL 33426-8232 | 2011-05-12 |
| 1992949853 | Keith Lee Buchholz | Emergency Medicine | 10155 Mangrove Dr #105, Boynton Beach, FL 33437-1001 | 2009-04-22 |
| 1649477134 | Kanwal Bawa | Emergency Medicine | 9945 Equus Cir, Boynton Beach, FL 33472 | 2007-06-28 |
| 1619992153 | Roberto Gines | Emergency Medicine | 3574 Quantum Lakes Drive, Boynton Beach, FL 33426 | 2006-07-13 |
| 1629070800 | Stanley Tenenbaum | Emergency Medicine | 7593 Boynton Beach Blvd, Boynton Beach, FL 33437 | 2005-06-01 |
| Find all providers in BOYNTON BEACH | ||||
| City | BOYNTON BEACH |
| Zip Code | 33435 |
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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.