Provider Type Icon

DR. BRUCE ALLEN WALLACE DO NPI 1881124816


NPI Information

NPI: 1881124816
Provider Name: DR. BRUCE ALLEN WALLACE, DO
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
401 S BALLENGER HWY
FLINT, MI
ZIP 48532
Phone: (810) 342-2000
Get Directions

DR. Bruce Allen Wallace, DO is an emergency medicine in Flint, MI with 7 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Bruce Allen Wallace, DO NPI is 1881124816. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year:2017

The provider's business location address is:

401 S BALLENGER HWY
FLINT, MI
ZIP 48532-638
Phone: (810) 342-2000

The NPI 1881124816 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)

The enumeration date for this NPI number is 6/13/2017 and was last updated on 9/28/2023.


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
1207P00000XEmergency Medicine02006388AINDIANANo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
3207P00000XEmergency Medicine5101025046MICHIGANYes

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

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.