Individual
DR. ADAM DONALD WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905
(507) 284-2511
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(608) 829-5485
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
036145300
IL
2084N0400X
Neurology Physician
67056-20
WI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
036145300
IL
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
67056-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386969079
—
WI
Enumeration date
04/06/2010
Last updated
05/05/2026
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