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Mark Wallace, MD
NPI 1083603088 · on the registry since 2005
Practice
- Address
- 1600 23rd Ave
Greeley, CO 80634 - Phone
- (970) 356-2424
- Fax
- (970) 346-2774
- Organisation at this address
- Banner Health
Colorado Dhca Greeley, Pllc
North Colorado Family Medicine
My Local Colorado Dental Practice, Llc
Excellence In Dentistry Of Greeley PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 103
Registry record
- Primary taxonomy
- Family Medicine Physician
207Q00000X
- Also registered as
- Family Medicine Physician
- Licence states on file
- CO, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-12-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado