DR. DUSTIN MARK WALLACE (NPI# 1679705214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679705214 |
| Entity Type | Individual |
| Full Name | DR. DUSTIN MARK WALLACE |
| Credential | M.D. |
| Practice Address |
1307 Federal St Suite B300 Pittsburgh PA 15212-4769 |
| Practice Telephone | 4123593751 |
| Practice Fax Number | 4123598439 |
| Mailing Telephone | 4123593751 |
| Mailing Fax Number | 4123598439 |
| Enumeration Date | 2009-08-16 |
| Last Update Date | 2014-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD438369 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1024783480001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667060 | Dustin Wade Wallace | Social Worker | 12475 E Laurel Ln, Scottsdale, AZ 85259-3457 | 2020-10-24 |
| 1770932808 | Dustin Guy Wallace | Dentist | 2801 S Olive St, Pine Bluff, AR 71603-5433 | 2016-06-09 |
| 1275906158 | Dustin W Wallace | Nurse Practitioner | 833 Princeton Ave Sw, Pob IIi; Suite 200a, Birmingham, AL 35211-1323 | 2015-11-02 |
| 1710143250 | Dustin P Wallace | Psychologist | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-08-04 |
| Street Address |
1307 FEDERAL ST SUITE B300 |
| City | PITTSBURGH |
| State | PA |
| Zip Code | 15212-4769 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518966670 | Radheshyam M. Agrawal | Internal Medicine | 1307 Federal St, Suite 301, Pittsburgh, PA 15212-4705 | 2005-07-20 |
| 1265064737 | Victor Cornelius Noble | Physician Assistant | 1307 Federal St, Pittsburgh, PA 15212-4769 | 2020-02-12 |
| 1760997423 | Nicole Julia Underwood | Physician Assistant | 1307 Federal St, Suite B201, Pittsburgh, PA 15212-4774 | 2017-12-04 |
| 1073046496 | Jessica Lynn Cook | Nurse Practitioner | 1307 Federal St, Suite 304, Pittsburgh, PA 15212-4769 | 2017-04-04 |
| 1881143931 | Ellen Stewart | Obstetrics & Gynecology | 1307 Federal St, Ste 300, Pittsburgh, PA 15212-4769 | 2016-09-30 |
| 1740633049 | Brittany Paterniti | Physician Assistant | 1307 Federal St, 2nd Floor, Pittsburgh, PA 15212-4769 | 2016-07-21 |
| 1265891527 | Andrew John Cubbison | Specialist/Technologist | 1307 Federal St, Pittsburgh, PA 15212-4769 | 2016-02-15 |
| 1396100749 | Theodore Marino Ezekiel Gagianas | Physician Assistant | 1307 Federal St, 2nd Floor, Pittsburgh, PA 15212-4769 | 2015-12-29 |
| 1770956906 | Caylie Jacob | Physician Assistant | 1307 Federal St, Suite 300, Pittsburgh, PA 15212-4769 | 2015-11-10 |
| 1396117818 | Eleanor A Deshone | Physician Assistant | 1307 Federal St, Suite 300, Pittsburgh, PA 15212-4769 | 2015-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770182347 | Kimberly Marie Pacy | Pharmacist | 623-625 East Ohio Street, Pittsburgh, PA 15212 | 2020-10-23 |
| 1649884990 | Genafie Mcknight | Social Worker | 322 North Shore Drive North Shore, Building 1b Suite 200, Pittsburgh, PA 15212 | 2020-09-03 |
| 1942818703 | Abraham Attah | Internal Medicine | 307 Federal Street, Suite B300, Pittsburgh, PA 15212 | 2020-07-17 |
| 1639705742 | Regi Jithesh | Nurse Practitioner | 314 E. North Avenue, Level One, Pittsburgh, PA 15212 | 2020-03-20 |
| 1598309262 | Anna Michaela Carter | Music Therapist | 322 North Shore Drive, Building 1b, Suite 200, Office 203, Pittsburgh, PA 15212 | 2019-11-05 |
| 1477196194 | Home Recovery Care, LLC | Case Management | 320 E. North Avenue, Cancer Institute Rm 203, Pittsburgh, PA 15212 | 2019-10-25 |
| 1558842997 | Maggie Yuhas | Occupational Therapist | 1411 Porterfield St, Pittsburgh, PA 15212 | 2018-08-23 |
| 1518464932 | Chloe Williams | Student in an Organized Health Care Education/Training Program | Allegheny General Hospital, 320 East North Ave, Pittsburgh, PA 15212 | 2018-04-11 |
| 1598261729 | Martha Conley Harrison | Student in an Organized Health Care Education/Training Program | West Penn Hospital, 4800 Friendship Ave, Pittsburgh, PA 15212 | 2018-04-05 |
| 1487155271 | Northside Dental | Dentist | 814 Cedar Avenue, Pittsburgh, PA 15212 | 2018-02-27 |
| Find all providers in zip 15212 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558976092 | Upmc Community Medicine, Inc | Internal Medicine | 5215 Centre Ave Ste 100, Pittsburgh, PA 15232-1303 | 2020-09-11 |
| 1609485168 | Allegheny Clinic | Internal Medicine | 1748 Jancey Street, Pittsburgh, PA 15206-1100 | 2020-07-30 |
| 1942818703 | Abraham Attah | Internal Medicine | 307 Federal Street, Suite B300, Pittsburgh, PA 15212 | 2020-07-17 |
| 1508491333 | Gabriel Perez Feliu | Internal Medicine | 5140 Liberty Ave Ste 150, Pittsburgh, PA 15224-2215 | 2020-03-12 |
| 1720627623 | St Clair Medical Services Inc | Internal Medicine | 1050 Bower Hill Rd Ste 301, Pittsburgh, PA 15243-1869 | 2019-12-26 |
| 1538701347 | Ann Elizabeth Patterson | Internal Medicine | 5700 Corporate Drive Suite 410, Pittsburgh, PA 15237 | 2019-10-14 |
| 1124582960 | William Paul Cunningham | Internal Medicine | Va Hospital, University Drive, University Drive, Pittsburgh, PA 15240 | 2019-01-25 |
| 1639663487 | Preferred Primary Care Physicians, Inc. | Internal Medicine | 2100 Jane St Ste 200, Pittsburgh, PA 15203-2076 | 2018-06-15 |
| 1710499868 | Preferred Primary Care Physicians, Inc. | Internal Medicine | 2100 Jane St Ste 201, Pittsburgh, PA 15203-2076 | 2017-10-30 |
| 1457881849 | Corinne Fanelli | Internal Medicine | 5200 Centre Ave Ste 409, Pittsburgh, PA 15232-1302 | 2017-06-18 |
| Find all providers in PITTSBURGH | ||||
| City | PITTSBURGH |
| Zip Code | 15212 |
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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.