DR. MARK RANDALL WALLACE (NPI# 1932104205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932104205 |
| Entity Type | Individual |
| Full Name | DR. MARK RANDALL WALLACE |
| Credential | MD |
| Practice Address |
13400 E Shea Blvd Scottsdale AZ 85259 |
| Mailing Address |
13400 E Shea Blvd Scottsdale AZ 85259-5452 |
| Practice Telephone | 4803018000 |
| Mailing Telephone | 4803018000 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 19816 | AZ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538533005 | Mark Thomas Wallace | Speech-Language Pathologist | 2337 N 2nd St, Harrisburg, PA 17110-1009 | 2015-11-21 |
| 1942241096 | Mark Alan Wallace | Chiropractor | 2140 W Poplar Ave, Suite 107, Collierville, TN 38017-0624 | 2006-06-09 |
| 1669467213 | Mark Spangler Wallace | Dentist | 168 N 1950 W Ste 202, Salt Lake City, UT 84116-3007 | 2005-09-20 |
| 1760753008 | Mark Edward Wallace | Psychiatry & Neurology | 77 7th Ave, #19d, New York, NY 10011-6645 | 2012-01-18 |
| 1205110434 | Mark James Wallace | Pharmacist | 301 S Sante Fe Ave, Edmond, OK 73003 | 2011-10-06 |
| 1932367539 | Mark Richard Wallace | Chiropractor | 9337 W 75th St, Overland Park, KS 66204 | 2008-05-30 |
| 1316119548 | Mark Steven Wallace | Hearing Instrument Specialist | 202 Grand Ave, Spencer, IA 51301 | 2008-03-27 |
| 1952591828 | Mark Allen Wallace | Otolaryngology | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-07-27 |
| 1104047190 | Mark C Wallace | Dentist | 50 County Road B E, Saint Paul, MN 55117-1927 | 2007-05-01 |
| 1548358047 | Mark Arthur Wallace | Dentist | 1901 Research Blvd, Suite 200, Rockville, MD 20850-3164 | 2006-10-10 |
| Street Address |
13400 E SHEA BLVD |
| City | SCOTTSDALE |
| State | AZ |
| Zip Code | 85259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598365884 | Evelyn Fennelly | Internal Medicine | 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 | 2020-10-27 |
| 1114525755 | Justin Michael Chitel | Student in an Organized Health Care Education/Training Program | 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 | 2020-10-15 |
| 1437757283 | Daniel Marston Herman | Nurse Anesthetist, Certified Registered | 13400 E Shea Blvd, Scottsdale, AZ 85259-5452 | 2020-10-14 |
| 1558969436 | Michael Patrick O'shea | Internal Medicine | 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 | 2020-10-13 |
| 1881201655 | Olivia Laurel Baker | Dietitian, Registered | 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 | 2020-09-25 |
| 1164036729 | Kathleen Alexis Howell Barrus | Genetic Counselor, MS | 13400 E Shea Blvd, Scottsdale, AZ 85259-5452 | 2020-09-01 |
| 1649889528 | Aditi Mishra | Surgery | 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 | 2020-07-27 |
| 1316556418 | Laura Ann Schaffer | Nurse Practitioner | 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 | 2020-07-24 |
| 1952910077 | Sarah Elizabeth Rebey | Physician Assistant | 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 | 2020-07-24 |
| 1932717949 | Jessica Marie Jordan | Student in an Organized Health Care Education/Training Program | 13400 E Shea Blvd, Scottsdale, AZ 85259-5452 | 2020-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053890541 | Irene Mitchell | Speech-Language Pathologist | 11445 E. Via Linda Suite 2235, Scottsdale, AZ 85259 | 2018-08-07 |
| 1437647237 | Meier Clinics of California, Inc. | Counselor | 10565 North 114th Street, Suite 107 - #8, Scottsdale, AZ 85259 | 2018-04-26 |
| 1477071215 | Swati Enhoffer | Pharmacist | 10500 E Mercer Ln, Scottsdale, AZ 85259 | 2017-08-31 |
| 1063964864 | Med Ride | Taxi | 10055 N. 142nd St.# 1130, Scottsdale, AZ 85259 | 2016-10-27 |
| 1639593759 | Dental Associates for Kids Only | Dentist | 12020 E. Shea Blvd. #8, Scottsdale, AZ 85259 | 2014-02-10 |
| 1750712725 | Sharon Nyquist | Nurse Practitioner | 13400 E Shea Blvd., Scottsdale, AZ 85259 | 2013-12-02 |
| 1598107070 | Wen D Tan | Physician Assistant | 13400 E. Shea Blvd, Scottsdale, AZ 85259 | 2013-07-24 |
| 1417295809 | Kristen L. Schaefer | Physician Assistant | 13400 E Shea Blvd Ste 100, Scottsdale, AZ 85259 | 2013-01-21 |
| 1518210004 | Ruth Aida Kosak | Podiatrist | 11390 E Via Linda #102, Scottsdale, AZ 85259 | 2012-10-21 |
| 1346590536 | Mairead Doherty | Internal Medicine | 13400 E. Shea Blvd., Scottsdale, AZ 85259 | 2012-09-14 |
| Find all providers in zip 85259 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801735 | Usaholistics | Internal Medicine | 6614 E Aster Dr, Scottsdale, AZ 85254-4549 | 2020-08-13 |
| 1184104812 | Medspa By Soul Surgery, LLC | Internal Medicine | 14362 N Frank Lloyd Wright Blvd Ste B109, Scottsdale, AZ 85260-8881 | 2018-08-21 |
| 1326539669 | B & D Medical Plc | Internal Medicine | 6501 E Greenway Pkwy # 103-449, Scottsdale, AZ 85254-2025 | 2018-05-22 |
| 1982109005 | Rupal Sujay Vora | Internal Medicine | 16544 N 109th Way, Scottsdale, AZ 85255-2427 | 2018-03-29 |
| 1629525191 | Ornelas Internal Medicine Pllc | Internal Medicine | 7331 E Osborn Dr Ste 420, Scottsdale, AZ 85251-6415 | 2016-09-01 |
| 1225582620 | Shruti Vishal Chaurasia Md Pllc | Internal Medicine | 9808 E Becker Ln, Scottsdale, AZ 85260-6208 | 2016-08-15 |
| 1508246398 | Alejandro Pineda | Internal Medicine | 3414 N 63rd Pl, Scottsdale, AZ 85251 | 2015-06-05 |
| 1114331394 | David Carmine Testa | Internal Medicine | 18525 N Scottsdale Rd Unit 4025, Scottsdale, AZ 85255 | 2014-06-17 |
| 1336552595 | Rucha Mehta Shah | Internal Medicine | 10210 N 92nd St Ste 202, Scottsdale, AZ 85258-4524 | 2014-06-05 |
| 1265852529 | Clark Steere Productions LLC | Internal Medicine | 8560 E Shea Blvd, Suite #130, Scottsdale, AZ 85260-6679 | 2014-04-24 |
| Find all providers in SCOTTSDALE | ||||
| City | SCOTTSDALE |
| Zip Code | 85259 |
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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.