LAURIE WALLACE


Address: 28050 Grand River Ave, Er Department, Farmington Hills, MI 48336-5919
Phone: 2484718000

LAURIE WALLACE (NPI# 1699716613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699716613
Entity Type Individual
Full Name LAURIE WALLACE
Credential DO
Practice Address 28050 Grand River Ave
Er Department
Farmington Hills
MI 48336-5919
Mailing Address Po Box 634087
Cincinnati
OH 45263-0001
Practice Telephone 2484718000
Mailing Telephone 8005408739
Mailing Fax Number 6169759827
Enumeration Date 2006-06-09
Last Update Date 2016-11-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207PE0004X Emergency Medicine
Specialization: Emergency Medical Services
LW010385 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI 114570889 05

Other Providers LAURIE WALLACE

NPI Name Taxonomy Address Enumeration
1083891287 Laurie Wallace Speech-Language Pathologist 24 Pole Plain Rd, Sharon, MA 02067-1741 2008-01-30
1770704306 Laurie Ann Wallace Physical Therapist 130 Loma Vista Dr, Burlingame, CA 94010 2007-05-01
1316076367 Laurie J Wallace Dietitian, Registered 10615 Cliffside St, Bakersfield, CA 93311-3718 2007-03-05
1831686369 Laurie Meagan Wallace Student in an Organized Health Care Education/Training Program 4700 Las Vegas Blvd N Bldg 1300, Las Vegas, NV 89191-6600 2018-04-19
1033542170 Laurie A. Wallace Nurse Practitioner 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 2013-08-13
1326261579 Laurie J Wallace Physician Assistant 1312 Middle Country Rd, Selden, NY 11784-2526 2007-04-10

Office Location

Street Address 28050 GRAND RIVER AVE
ER DEPARTMENT
City FARMINGTON HILLS
State MI
Zip Code 48336-5919

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003811662 Jyothsna Yalavarthi Internal Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2005-06-20
1649895848 Tehreem Sajjad Podiatrist 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-06-12
1700401064 Anthony Ibrahim Pharmacy 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-06-12
1700401155 Darlene Pham Emergency Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-06-11
1497370050 Lawrence Jajou Orthopaedic Surgery 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-06-10
1548885072 Ricardo Hernandez Orthopaedic Surgery 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-06-10
1669096335 Krystle Gish Family Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-05-29
1588288278 Jordan Matthew Correll Family Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-05-29
1053934760 Brandon Baroff Emergency Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-05-28
1912520651 Aaron W Hess Emergency Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2020-05-27
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932733375 Compassionate Attendant Care Inc Home Health 21100 Osmus Street, Suite E, Farmington Hills, MI 48336 2020-02-25
1578123790 Jon Boynton Audiologist-Hearing Aid Fitter 25882 Orchard Lake Rd, Suite 103, Farmington Hills, MI 48336 2019-06-19
1083270078 Bethesda Home Health LLC Home Health 34445 Northwestern Hwy, Farmington Hills, MI 48336 2019-05-15
1174005227 Cisseri Health Care Home Health 28931 W 11 Mile Rd, Farmington Hills, MI 48336 2018-09-05
1326531294 April A Jackson Psychologist 24211 Farmington Road, Farmington Hills, MI 48336 2018-06-14
1083136642 Nicole Renee Cannonier Social Worker 25311 Lynford, Farmington Hills, MI 48336 2017-07-14
1174052021 Sharon Suzanne King Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 21600 Tulane, Farmington Hills, MI 48336 2017-06-05
1639578909 Alyssa Kaitlyn Brecht Rehabilitation Counselor 23062 Middlebelt Rd, Apt 103, Farmington Hills, MI 48336 2014-08-22
1184038341 Therapeutic Advantage LLC Occupational Therapist 30903 W 10 Mile Rd Ste B, Farmington Hills, MI 48336 2014-06-16
1952727257 Takara Orum Social Worker 21399 Tulane Ave, Apt. 301, Farmington Hills, MI 48336 2014-03-11
Find all providers in zip 48336

Taxonomy Information

Taxonomy Code 207PE0004X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine
Specialization Emergency Medical Services

Taxonomy Definition

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013958016 Diane L Kaiser Emergency Medicine 28050 Grand River Avenue, Farmington Hills, MI 48336 2006-06-09
1841585312 Stephen John Lojewski Jr. Emergency Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2011-06-13
1902199938 Gregory Dubrovich Emergency Medicine 28050 Grand River Ave, Farmington Hills, MI 48336-5919 2011-05-24
1700810868 Robert W Mathews Emergency Medicine 28050 Grand River Avenue, Er Department, Farmington Hills, MI 48336 2006-07-11
1962436733 Matthew A Warpinski Emergency Medicine 28050 Grand River Avenue, Farmington Hills, MI 48336 2006-07-10
1245264159 Dawn Zelenka-joshowitz Emergency Medicine 28050 Grand River Ave, Er Department, Farmington Hills, MI 48336 2006-07-10
1497789309 Darrell Vlachos Emergency Medicine 28050 Grand River Avenue, Er Department, Farmington Hills, MI 48336 2006-07-10
1831130830 Diane M Paratore Emergency Medicine 28050 Grand River Avenue, Er Department, Farmington Hills, MI 48336 2006-06-09
1023059037 Richard W Traicoff Emergency Medicine 28050 Grand River Avenue, Er Department, Farmington Hills, MI 48336 2006-06-09
1922049931 Frank W Schell Emergency Medicine 28050 Grand River Ave, Er Department, Farmington Hills, MI 48336 2006-06-09
Find all providers in FARMINGTON HILLS

Competitor

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City FARMINGTON HILLS
Zip Code 48336

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Dataset Information

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.

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