ELIZABETH WALLEN MD NPI 1285634071

NPI Information

NPI: 1285634071
Provider Name: ELIZABETH WALLEN, MD
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
20 CALLE CAL
SANTA FE, NM
ZIP 87508
Phone: (614) 266-8533
Get Directions

Elizabeth Wallen, MD is a general practice in Santa Fe, NM. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Elizabeth Wallen, MD NPI is 1285634071. 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:

20 CALLE CAL
SANTA FE, NM
ZIP 87508
Phone: (614) 266-8533

The NPI 1285634071 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/22/2005 and was last updated on 5/15/2018.

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	License Number	License State	Primary
1	207L00000X	Anesthesiology	35055437	OHIO	No
2	208000000X	Pediatrics	35-055437	OHIO	No
3	208D00000X	General Practice	MD000025868	NEW MEXICO	No
4	208D00000X	General Practice	MD43857E	PENNSYLVANIA	No
5	208D00000X	General Practice	35.055437	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	Other Provider Identifier Issuer
1	0665945	MEDICAID	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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