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GONZALO WALLIS MD NPI 1417179078


NPI Information

NPI: 1417179078
Provider Name: GONZALO WALLIS, MD
Classification: Pediatrics - 2080P0202X
Entity Type: Individual

Specialization: Pediatric Cardiology

Organization: CAROLINAS PHYSICIANS NETWORK INC

PECOS Registration: Yes

Address:
1001 BLYTHE BLVD
STE 500
CHARLOTTE, NC
ZIP 28203
Phone: (704) 373-1813
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Gonzalo Wallis, MD is a pediatric cardiology pediatrics in Charlotte, NC with 23 years of experience. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. Gonzalo Wallis, MD NPI is 1417179078. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1001 BLYTHE BLVD
STE 500
CHARLOTTE, NC
ZIP 28203-866
Phone: (704) 373-1813

The NPI 1417179078 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 5/3/2007 and was last updated on 1/5/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0202XPediatricsPediatric Cardiology36637SOUTH CAROLINANo
22080P0202XPediatricsPediatric Cardiology2013-02269NORTH CAROLINAYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.