DR. MICHAEL WALLACE O.D. NPI 1689615346

NPI Information

  • NPI: 1689615346
  • Provider Name: DR. MICHAEL WALLACE, O.D.
  • Classification: Optometrist - 152W00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1379 FLUSHING RD
    FLUSHING, MI
    ZIP 48433
  • Phone: (810) 659-3135

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NPI Details

DR. Michael Wallace, O.D. is an optometrist in Flushing, MI with 40 years of experience. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. DR. Michael Wallace, O.D. NPI is 1689615346. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: FERRIS STATE COLLEGE - COLLEGE OF OPTOMETRY
Graduation Year:1986

The provider's business location address is:

1379 FLUSHING RD
FLUSHING, MI
ZIP 48433-262
Phone: (810) 659-3135
Fax: (810) 659-0024

The NPI 1689615346 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).

The enumeration date for this NPI number is 6/10/2006 and was last updated on 5/7/2009.

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
1152W00000XOptometrist4901003070MICHIGANYes

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
1944885903MEDICAIDMICHIGAN
24194781MEDICARE PINOHIO
3900B566350OTHERMICHIGANBCBS OF MI
4900B514120OTHERMICHIGANBLUE CARE NETWORK
5U33233MEDICARE UPINMICHIGAN
62678599MEDICAIDOHIO
7P31450001MEDICARE PINMICHIGAN
80N21210001MEDICARE PINMICHIGAN
9P00374947MEDICARE PINOHIO

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: 11/21/2025

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