Individual
DR. EDWARD ALTON WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
13597
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135972
—
SC
01
—
570835798
STANDARD TAX ID
SC
05
—
5900433
—
NC
01
—
E0051
MEDCOST
SC
Enumeration date
01/25/2007
Last updated
12/21/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up