DR. CELESTE NICOLE WALLACE D.O. NPI 1740252576

NPI Information

NPI: 1740252576
Provider Name: DR. CELESTE NICOLE WALLACE, D.O.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
802 GREEN VALLEY RD
SUITE 210
GREENSBORO, NC
ZIP 27408
Phone: (336) 802-2536
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DR. Celeste Nicole Wallace, D.O. is a pediatrics in Greensboro, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Celeste Nicole Wallace, D.O. NPI is 1740252576. 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:

802 GREEN VALLEY RD
SUITE 210
GREENSBORO, NC
ZIP 27408-041
Phone: (336) 802-2536
Fax: (336) 802-2534

The enumeration date for this NPI number is 2/6/2006 and was last updated on 1/16/2013.

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	208000000X	Pediatrics		34--008564	OHIO	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
1	W4166381	MEDICARE ID-TYPE UNSPECIFIED	OHIO
2	2583520	MEDICAID	OHIO
3	I38022	MEDICARE UPIN	OHIO

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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