GEORGE F. WALLACE D.P.M. NPI 1811001696

NPI Information

  • NPI: 1811001696
  • Provider Name: GEORGE F. WALLACE, D.P.M.
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • Address: 90 BERGEN ST
    DOC 4500
    NEWARK, NJ
    ZIP 07103
  • Phone: (973) 972-2500

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NPI Details

George F. Wallace, D.P.M. is a foot and ankle surgery podiatrist in Newark, NJ. George F. Wallace, D.P.M. NPI is 1811001696. 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:

90 BERGEN ST
DOC 4500
NEWARK, NJ
ZIP 07103-425
Phone: (973) 972-2500
Fax: (973) 972-2510

The enumeration date for this NPI number is 8/18/2006 and was last updated on 8/26/2009.

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
1213ES0103XPodiatristFoot & Ankle Surgery25MD00137200NEW JERSEYYes

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
1T45622MEDICARE UPINNEW JERSEY
21567101MEDICAIDNEW JERSEY
3505579MEDICARE PINNEW JERSEY

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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