Dr. Shana Dale Wallace
MD | Neurology
1900 Randolph Rd, Suite 1010, Charlotte
North Carolina, 28207-1122
704-384-1390 704-384-1063
Maps & DirectionsDr. 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.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.