Wallace, Robert B
Wallace, Robert B is an individual health care provider with primary practice located at 200 Hawkins Dr , Iowa City IA 52242-1009. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wallace, Robert B can be contacted via phone (319) 384-5005.Contact Information
Primary practice address
200 Hawkins Dr
Iowa City IA 52242-1009
Phone: (319) 384-5005
Fax: (319) 384-5004
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 18838 | Iowa |
Profile Details
| NPI number | 1417920711 |
|---|---|
| LBN Legal business name | Wallace, Robert B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Dec 19th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417920711 | NPPES |
| Iowa | MEDICAID | 095539 | |
| Iowa | Other | 09553 |
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