DR. MARY ANDERSON WALLACE M.D. NPI 1215109228

NPI Information

NPI: 1215109228
Provider Name: DR. MARY ANDERSON WALLACE, M.D.
Classification: Hospitalist - 208M00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1400 E BOULDER ST
COLORADO SPRINGS, CO
ZIP 80909
Phone: (303) 338-4545
Get Directions

DR. Mary Anderson Wallace, M.D. is a hospitalist in Colorado Springs, CO with 16 years of experience. The provider is hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. DR. Mary Anderson Wallace, M.D. NPI is 1215109228. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1400 E BOULDER ST
COLORADO SPRINGS, CO
ZIP 80909-533
Phone: (303) 338-4545

The NPI 1215109228 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/31/2008 and was last updated on 9/27/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		49780	COLORADO	No
2	208M00000X	Hospitalist		DR.0049780	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	94831076	MEDICAID	COLORADO
2	029236	OTHER	COLORADO	KAISER COMMERCIAL NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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