Diane S Wallace (NPI# 1194764647, PAC ID# 8123120656) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1194764647 |
| PAC ID by PECOS | 8123120656 |
| Professional Enrollment ID | I20160112002072 |
| Full Name | Diane S Wallace |
| Organization Legal Name | FOX CHASE EMERGENCY PHYSICIANS LLC |
| Address |
35750 Us 19 Palm Harbor FL 34684-1703 |
| Phone Number | 7277898420 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF VERMONT COLLEGE OF MEDICINE |
| Graduation Year | 1995 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1355638404 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100191 | MEDICAL CENTER OF TRINITY |
| Address | Phone | Organization |
|---|---|---|
| 35750 Us 19, Palm Harbor, FL 34684-1703 | 7277898420 | FOX CHASE EMERGENCY PHYSICIANS LLC |
| Organization Legal Name | FOX CHASE EMERGENCY PHYSICIANS LLC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bryce B Shedlock | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Thaer Mf Abukhalil | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Thomas F Payton | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Christopher M Scipione | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Ebrahim H Karkevandian | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Scott T Rouse | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Kenneth M Degraaf | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Street Address |
35750 US 19 |
| City | PALM HARBOR |
| State | FL |
| Zip | 34684-1703 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bryce B Shedlock | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Thaer Mf Abukhalil | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Thomas F Payton | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Christopher M Scipione | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Ebrahim H Karkevandian | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Scott T Rouse | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Kenneth M Degraaf | Emergency Medicine | Fox Chase Emergency Physicians LLC | 35750 Us 19, Palm Harbor, FL 34684-1703 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| George F Williams Iv | Podiatry | 34921 Us Hwy 19 N, Suite 400, Palm Harbor, FL 34684 | |
| Ananda Som | Internal Medicine | 30522 Us 19, Suite 109, Palm Harbor, FL 34684 | |
| Ronald Williams | Orthopedic Surgery | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| Brandon Adrian Taylor | Orthopedic Surgery | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| Brian Maiocco | Orthopedic Surgery | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| Andrew Maser | Orthopedic Surgery | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| Erin Zalta | Physical Therapy | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| Keri Ann Stablein | Physical Therapy | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| John Gill Sullivan | Orthopedic Surgery | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| Scott L Brotherton | Orthopedic Surgery | Orthopedic Specialists | 37026 Us Hwy 19 N, Palm Harbor, FL 34684-1109 |
| Find all physicians in zip 34684 | |||
| City | PALM HARBOR |
| Zip Code | 34684 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | PALM HARBOR + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Diane S Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.