DR. ADAM N WALLACE (NPI# 1801117585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801117585 |
| Entity Type | Individual |
| Full Name | DR. ADAM N WALLACE |
| Credential | MD |
| Practice Address |
2301 N Lake Dr Ste 1104 Milwaukee WI 53211-4508 |
| Practice Telephone | 4142159375 |
| Practice Fax Number | 4145853229 |
| Mailing Telephone | 4145853223 |
| Mailing Fax Number | 4145853229 |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2019-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
70505-20 | WI | Allopathic & Osteopathic Physicians |
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
61898 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7505 Metro Blvd Ste 400, Edina, MN 55439 | (612) 573-2200 | 6125732274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518129733 | Adam Joseph Wallace | Anesthesiology | 3336 E 32nd St Ste 220, Tulsa, OK 74135-4442 | 2008-06-29 |
| 1700317898 | Adam Wallace | Student in an Organized Health Care Education/Training Program | 513 Parnassus Ave, S-321, San Francisco, CA 94143-2205 | 2017-03-21 |
| 1235450297 | Adam K Wallace | Nurse Anesthetist, Certified Registered | 616 19th St, Columbus, GA 31901-1528 | 2010-06-14 |
| 1386969079 | Adam Donald Wallace | Psychiatry & Neurology | 200 1st St Sw, Rochester, MN 55905 | 2010-04-06 |
| Street Address |
2301 N LAKE DR STE 1104 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306457163 | Karissa Bowman | Nurse Practitioner | 2301 N Lake Dr Ste 1104, Milwaukee, WI 53211-4508 | 2020-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
| Find all providers in zip 53211 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952477929 | Daniel Peter Gibson | Radiology | 3237 S 16th St, Milwaukee, WI 53215-4526 | 2006-11-28 |
| 1982781373 | Darren P O'neill | Radiology | 9200 W Wisconsin Ave, Department of Radiology, Milwaukee, WI 53226-3522 | 2006-11-01 |
| 1447333232 | Sonia Boparai Gill | Radiology | 9200 W Wisconsin Ave, Department of Radiology, Milwaukee, WI 53226-3522 | 2006-10-23 |
| 1760419337 | Jonathan E Jennings | Radiology | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2006-06-27 |
| 1487607263 | Robert J Rilling | Radiology | 9200 W Wisconsin Ave, Department of Radiology, Milwaukee, WI 53226-3522 | 2006-05-19 |
| 1932151636 | Scott D Rand | Radiology | 9200 W Wisconsin Ave, Dept of Radiology, Milwaukee, WI 53226-3522 | 2006-05-17 |
| 1821041567 | Michelle M Michel | Radiology | 9200 W Wisconsin Ave, Department of Radiology, Milwaukee, WI 53226-3522 | 2006-05-17 |
| 1114970852 | Leighton Mark | Radiology | 9200 W Wisconsin Ave, Department of Radiology, Milwaukee, WI 53226-3522 | 2006-05-17 |
| 1306898663 | John L Ulmer | Radiology | 9200 W Wisconsin Ave, Department of Radiology, Milwaukee, WI 53226-3522 | 2006-05-16 |
| 1255382099 | Mehmet Kocak | Radiology | 9200 W Wisconsin Ave, Hospital Based @ Froedtert Hosp., Milwaukee, WI 53226-3522 | 2006-05-15 |
| Find all providers in MILWAUKEE | ||||
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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.