DR. BRUCE J WALLACE (NPI# 1811088933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811088933 |
| Entity Type | Individual |
| Full Name | DR. BRUCE J WALLACE |
| Credential | M.D. |
| Practice Address |
699 Sierra Rose Dr Ste A Reno NV 89511-2069 |
| Practice Telephone | 7758238166 |
| Mailing Telephone | 7758238166 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 3504 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 0020-16115 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881124816 | Bruce Allen Wallace Jr. | Emergency Medicine | 401 S Ballenger Hwy, Flint, MI 48532-3638 | 2017-06-13 |
| Street Address |
699 SIERRA ROSE DR STE A |
| City | RENO |
| State | NV |
| Zip Code | 89511-2069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336259183 | Nevada Urology Associates | Urology | 699 Sierra Rose Dr Ste A, Reno, NV 89511-2069 | 2006-08-30 |
| 1720179849 | David P Berry | Urology | 699 Sierra Rose Dr Ste A, Reno, NV 89511-2069 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407474695 | Katherine Lynn Mauldin | Physician Assistant | Redfield Campus Nell J. Redfield Bldg. A Suite 104, 18600 Wedge Parkway, Reno, NV 89511 | 2020-07-14 |
| 1902428915 | Roxann Jeanette Richardson | Student in an Organized Health Care Education/Training Program | Unr Redfield Campus Nell J. Redfield Bldg. A, Suite 104 18600 Wedge Parkway, Reno, NV 89511 | 2020-05-13 |
| 1487286654 | Noelle Marie Davis-marinaccio | Nurse Practitioner | 5570 Longley Lane, Reno, NV 89511 | 2020-02-06 |
| 1265092662 | Elysia Jones | Student in an Organized Health Care Education/Training Program | 18600 Wedge Parkway, Nell J. Redfield Building A, Suite 104, Reno, NV 89511 | 2019-06-18 |
| 1023583622 | Vera Whole Health, Wa PC | Clinic/Center | 699 Sierra Rose Drive, Reno, NV 89511 | 2018-10-10 |
| 1841786027 | Christina Willett | Speech-Language Pathologist | 14680 S. Quiet Meadow Drive, Reno, NV 89511 | 2018-07-10 |
| 1235630864 | High Sierra Psychiatry, LLC | Clinic/Center | Reno Behavioral Healthcare Hospital, 6940 Sierra Center Parkway, Reno, NV 89511 | 2018-02-28 |
| 1154839637 | Jacob Blake, Md Ltd. | Anesthesiology | 5590 Kietzke Lane, Reno, NV 89511 | 2018-01-18 |
| 1548776024 | Jennifer L. Shane O.d., Ltd | Optometrist | 5385 Reno Corporate Drive #100, Reno, NV 89511 | 2017-12-20 |
| 1619488525 | Reno Behavioral Healthcare Hospital, LLC | Psychiatric Hospital | 6940 Sierra Center Parkway, Reno, NV 89511 | 2017-10-18 |
| Find all providers in zip 89511 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013008135 | Angelo W Kanellos | Urology | 10745 Double R Blvd, Reno, NV 89521-8979 | 2006-09-27 |
| 1336259183 | Nevada Urology Associates | Urology | 699 Sierra Rose Dr Ste A, Reno, NV 89511-2069 | 2006-08-30 |
| 1770540064 | Joseph B Drew | Urology | 5560 Kietzke Ln, Bldg A, Reno, NV 89511-3019 | 2006-04-28 |
| 1437116704 | Christine N Lajeunesse | Urology | 1490 Stardust St, Reno, NV 89503-4238 | 2006-04-28 |
| 1518924943 | Steven L Moss | Urology | 1500 E Second St, Suite 300, Reno, NV 89502-1198 | 2006-04-28 |
| 1841257235 | Jonathan S Garey-sage | Urology | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2006-04-28 |
| 1477510865 | Thomas W Brady | Urology | 1500 E Second St., Suite 300, Reno, NV 89502-1198 | 2006-04-28 |
| 1669439048 | John G Scott | Urology | 5560 Kietzke Ln Bldg A, Reno, NV 89511-3019 | 2006-04-28 |
| 1437711330 | Lexi Sara Jacobson | Urology | 10745 Double R Blvd, Reno, NV 89521-8979 | 2019-07-01 |
| 1821564360 | Jamie Peatrowsky | Urology | 5560 Kietzke Ln, Bldg A, Reno, NV 89511 | 2018-10-23 |
| Find all providers in RENO | ||||
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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.