DR. DAVID MICHAEL WALLACE SR. (NPI# 1134285810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134285810 |
| Entity Type | Individual |
| Full Name | DR. DAVID MICHAEL WALLACE SR. |
| Credential | M.D. |
| Practice Address |
200 Eaton St Hampton VA 23669-4000 |
| Practice Telephone | 7577265000 |
| Practice Fax Number | 7577265001 |
| Mailing Telephone | 7577265000 |
| Mailing Fax Number | 7577265001 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0101269450 | VA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 043144 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| P10500 Mount Bellevedere Drive, Attn: Deputy Cdr for Clinical Services (dccs), Fort Drum, NY 13602 | 3157724021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700327061 | David Wallace | Student in an Organized Health Care Education/Training Program | 24606 Mosquero Ln, Mission Viejo, CA 92691-4913 | 2017-03-19 |
| 1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
| 1386868487 | David Stuart Wallace | Chiropractor | 2330 Highway 94 South Outer Rd, Saint Charles, MO 63303-8301 | 2007-04-12 |
| 1649343641 | David Michael Wallace | Chiropractor | 112 W Grand Ave, Rainbow City, AL 35906-3233 | 2006-11-16 |
| 1932193604 | David Wallace | Anesthesiology | 738 Golden Pheasant Dr, Draper, UT 84020-8454 | 2005-09-08 |
| 1386646206 | David Allen Wallace | Dentist | 206 S Walker St, Princeton, WV 24740-2747 | 2005-08-11 |
| 1295736809 | David B. Wallace | Radiology | 325 N Highland Ave, Provena Mercy Medical Center, Aurora, IL 60506-3811 | 2005-08-04 |
| 1679576276 | David Alan Wallace | Ophthalmology | 11600 Wilshire Blvd, Ste 200, Los Angeles, CA 90025-1782 | 2005-05-27 |
| 1619596335 | David Alexander Wallace | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2020-04-13 |
| 1396364402 | David Carter Wallace | Student in an Organized Health Care Education/Training Program | 620 Shadow Ln, Las Vegas, NV 89106-4119 | 2020-04-09 |
| Street Address |
200 EATON ST |
| City | HAMPTON |
| State | VA |
| Zip Code | 23669-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689648164 | Anthony P Fisher | Family Medicine | 200 Eaton St, Hampton, VA 23669 | 2006-02-14 |
| 1932695517 | Dylan Miguel George | Nurse Practitioner | 200 Eaton St, Hampton, VA 23669-4000 | 2018-07-06 |
| 1215294251 | Beata Barreto | Family Medicine | 200 Eaton St, Hampton, VA 23669-4000 | 2012-04-16 |
| 1770864035 | Amanda Caree Almond | Nurse Practitioner | 200 Eaton St, Hampton, VA 23669-4000 | 2011-08-31 |
| 1326165929 | Sentara Medical Group | Durable Medical Equipment & Medical Supplies | 200 Eaton St, Hampton, VA 23669-4000 | 2007-03-26 |
| 1205801339 | Kathryn A Caufield | Nurse Practitioner | 200 Eaton St, Hampton, VA 23669 | 2006-02-22 |
| 1558336867 | Todd A Weisman | Family Medicine | 200 Eaton St, Hampton, VA 23669-4000 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225519325 | Morgan Mead | Dietitian, Registered | Usaf Hospital, 77 Nealy Ave, Apo, AA 23669 | 2018-08-27 |
| 1689193690 | Tisha Marie Payne | In Home Supportive Care | 52 Old Hampton Ln Suite F, Hampton, VA 23669 | 2017-09-12 |
| 1275063372 | Crystal Sharps | Registered Nurse | 27 Rockingham Dr, Hampton, VA 23669 | 2017-06-13 |
| 1851826945 | Icare Health Care Services, LLC | Home Health | 1314 Willnew Dr, Hampton, VA 23669 | 2017-04-26 |
| 1790132173 | Jennifer Jones-hicks | Speech-Language Pathologist | 67 Red Robin Turn, Hampton, VA 23669 | 2016-05-16 |
| 1316313588 | Elizabeth Anne Brewer | Physical Therapist | 23 Curle Road, Hampton, VA 23669 | 2015-08-11 |
| 1497132146 | Felicia Walker | Driver | 129 Settlers Landing Rd, Hampton, VA 23669 | 2015-05-01 |
| 1821375858 | Alabaster Anointed Home Care LLC | Home Health | 703 Essex Park Drive, Hampton, VA 23669 | 2011-11-04 |
| 1649414269 | Genesis Healthcare | Rehabilitation Hospital | 113 Atwell Lane, Hampton, VA 23669 | 2009-04-27 |
| 1578826004 | Snorebiz | Clinic/Center | 638 Kings View Ct, Hampton, VA 23669-1014 | 2012-06-19 |
| Find all providers in zip 23669 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053843987 | Jessica Weng | Family Medicine | 191 Fox Hill Rd Ste D, Hampton, VA 23669-2360 | 2017-03-30 |
| 1831621887 | Allen Family Healthcare LLC | Family Medicine | 149 Berkeley Way, Hampton, GA 30228-4082 | 2017-03-29 |
| 1700174117 | Rodney Leron Thompson | Family Medicine | Patient First - Hampton, 2304 W Mercury Blvd, Hampton, VA 23666 | 2011-07-19 |
| 1255626602 | Daniel Adrian Whitelocke | Family Medicine | 402 S Lee St, Hampton, AR 71744-8615 | 2011-06-14 |
| 1386893592 | Carlos F Acosta Md Ltd | Family Medicine | 2100 Hartford Rd, Hampton, VA 23666-2409 | 2008-09-11 |
| 1396908067 | Robert Scott Fell | Family Medicine | 850 Enterprise Pkwy Ste 2200, Hampton, VA 23666-6252 | 2008-07-03 |
| 1578781704 | Shahbaz Khan | Family Medicine | 850 Gateway Blvd., Hampton, VA 23666 | 2007-04-23 |
| 1477680858 | Tidewater Family Medicine, P C | Family Medicine | 2114a Hartford Rd, Hampton, VA 23666-2409 | 2007-02-27 |
| 1720150246 | North Hunterdon Physician Assoc | Family Medicine | 37 Rupell Rd, Hampton, NJ 08827 | 2006-11-14 |
| 1740350669 | Shirin Valiani | Family Medicine | 25 Goss Drive, Hampton, GA 30228-1855 | 2006-11-08 |
| Find all providers in HAMPTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.