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Individual
DR. ADAM N WALLACE
Active
Individual
DR. ADAM N WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
036.148822
IL
2084N0400X
Neurology Physician
70505
WI
2084N0400X
Neurology Physician
70505-20
WI
2085N0700X
Neuroradiology Physician
Primary
036.148822
IL
2085N0700X
Neuroradiology Physician
61898
MN
2085N0700X
Neuroradiology Physician
70505-20
WI
2085R0202X
Diagnostic Radiology Physician
036.148822
IL
2085R0202X
Diagnostic Radiology Physician
2015013114
MO
2085R0202X
Diagnostic Radiology Physician
319983
NY
2085R0202X
Diagnostic Radiology Physician
70505-20
WI
2085R0202X
Diagnostic Radiology Physician
DR.0068906
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200021565
—
MO
Enumeration date
06/17/2010
Last updated
04/22/2026
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