Individual
WALLACE DALE PROPHET
Active
Individual
WALLACE DALE PROPHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
49643
MT
207RP1001X
Pulmonary Disease Physician
9734
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000012909
—
AL
05
—
00284468A
—
GA
05
—
068414700
—
FL
Enumeration date
09/09/2005
Last updated
08/22/2017
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