Individual
DR. ERIC L WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
700 W IRONWOOD DR, 320, COEUR D ALENE, ID 83814-2656
(208) 625-5250
Mailing address
700 W IRONWOOD DR, 320, COEUR D ALENE, ID 83814-2656
(208) 625-5250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
03263
KY
207R00000X
Internal Medicine Physician
2007-014326
NC
207RC0000X
Cardiovascular Disease Physician
O0839
ID
207RI0011X
Interventional Cardiology Physician
Primary
O-0839
ID
207RI0011X
Interventional Cardiology Physician
OP60505950
WA
Other
Enumeration date
09/17/2007
Last updated
07/25/2025
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