Shana Dale Wallace in Charlotte - Neurodevelopmental Disabilities
Shana Dale Wallace - NPI 1013040666
Shana Dale Wallace is a Neurodevelopmental Disabilities in Charlotte, North Carolina. Shana Dale Wallace practices all healthcare services and medical treatments related to Neurodevelopmental Disabilities. The NPI Number for Shana Dale Wallace is 1013040666. The last update date is 2020-10-25.
Shana Dale Wallace's current location address is Po Box 60447, Charlotte, North Carolina. You can contact this provider via phone number 7043841390 and fax number 7043841063. The mailing address for Shana Dale Wallace is Po Box 60447, Charlotte, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shana Dale Wallace |
|---|---|
| Address | Po Box 60447, Charlotte, North Carolina |
| Phone Number | 7043841390 |
| Fax Number | 7043841063 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1013040666 |
|---|---|
| Provider Enumeration Date | 2007-03-13 |
| Last Updated Date | 2020-10-25 |
Provider Mailing Address Detail
| Address | Po Box 60447 |
|---|---|
| City | Charlotte |
| State | North Carolina (NC) |
| Post Code | 282600447 |
| Phone Number | 7043841390 |
| Fax Number | 7043841063 |
Provider's Primary Taxonomy Detail
| Speciality | Neurodevelopmental Disabilities |
|---|---|
| Taxonomy | 2080P0008X |
| Licence No | 2004-01063 |
|
Definition: A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5907566 | NC | -- | |
| 200401063 | NC | MEDICAL LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Shana Dale Wallace by the Centers for Medicare & Medicaid Services?
The Shana Dale Wallace has been issued the NPI (National Provider Identifier) 1013040666 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Shana Dale Wallace's physical address?
The Shana Dale Wallace is physically located at Po Box 60447, in the city of Charlotte, NC, with the postal code 282600447.
What is Shana Dale Wallace's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Shana Dale Wallace's specialized field of practice is Neurodevelopmental Disabilities, and the corresponding taxonomy code that categorizes this area of specialization is 2080P0008X.
On what date did the Centers for Medicare & Medicaid Services assign the 1013040666 to Shana Dale Wallace?
The Centers for Medicare & Medicaid Services assigned the 1013040666 to Shana Dale Wallace on 2007-03-13.
As of what date was the information regarding Shana Dale Wallace, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Shana Dale Wallace, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-10-25.
NPI Number: 1720081763
Address: 675 E Highway 60, Hardinsburg, KY