Wallace, David W

Wallace, David W is an individual health care provider with primary practice located at 515 Hospital Dr Suite 1, Shelbyville KY 40065-1640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wallace, David W can be contacted via phone (502) 633-3525.

Contact Information

Primary practice address
515 Hospital Dr Suite 1 Shelbyville KY 40065-1640
Phone: (502) 633-3525
Fax: (502) 633-8075
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22054 Kentucky

Profile Details

NPI number 1376532168
LBN Legal business name Wallace, David W
Credentials MD MBA
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376532168 NPPES
Other 0100487 UHC
Other P00872496 UHC
Other 000000048268 UHC
MEDICAID 64220544 UHC

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