Dr. Shana Dale Wallace is a Charlotte, North Carolina based neurologist who is specialized in Neurology. Active license number of Dr. Shana Dale Wallace is 200401063 for Child Neurology in North Carolina. Her current practice location is 1900 Randolph Rd, Suite 1010, Charlotte. Patients can reach her at 704-384-1390 or can fax her at 704-384-1063. Dr. Shana Dale Wallace is MD in Neurology and her NPI number (Unique professional ID assigned by NPPES) is 1013040666. Dr. Shana Dale Wallace specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Complete Profile:
Dr. Shana Dale Wallace speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
Name:
Dr. Shana Dale Wallace
Specialization:
Neurology
Gender:
Female
Credentials:
MD
Practice Address:
1900 Randolph Rd, Suite 1010, Charlotte, North Carolina, 28207-1122
Phone:
704-384-1390
Fax:
704-384-1063
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1013040666
NPI Enumeration Date:
13 Mar, 2007
NPI Last Update On:
25 Oct, 2020
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Shana Dale Wallace are as mentioned below.
License Number
Specialization
State
Status
200401063
Child Neurology
North Carolina
Primary
2004-01063
Pediatrics
North Carolina
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Shana Dale Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
5907566
Medicaid
North Carolina
200401063
Other
North Carolina
MEDICAL LICENSE
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Dr. Shana Dale Wallace Po Box 60447, Charlotte, North Carolina
Zip:
28260-0447
Phone Number:
704-384-1390
Fax Number:
704-384-1063
Patients can reach Dr. Shana Dale Wallace at 1900 Randolph Rd, Suite 1010, Charlotte, North Carolina or can call to book an appointment on 704-384-1390.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.