Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SHANA DALE WALLACE, MD
ActiveDR. SHANA DALE WALLACE, MD is a Neurology with Special Qualifications in Child Neurology healthcare provider located in CHARLOTTE, North Carolina. NPI 1013040666 is currently active in the NPPES registry. Verify at CMS.
Neurology with Special Qualifications in Child Neurology · CHARLOTTE, NC
Registration Details
- NPI Number
- 1013040666
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 13, 2007 (19.414360985026 yrs)
- Last Updated
- Oct 25, 2020
- Licenses
-
2004-01063 (NC)200401063 (NC)
Practice Information
- Address
-
1900 RANDOLPH RDSUITE 1010CHARLOTTE, NC, 282071122Browse NC providers · Browse ZIP 28207
- Phone
- 7043841390
- Fax
- 7043841063
- Primary Specialty
-
Neurology with Special Qualifications in Child Neurology
2084N0402X
- Additional Specialty
- Neurology with Special Qualifications in Child Neurology
Other Neurology with Special Qualifications in Child Neurology Providers in CHARLOTTE, NC
| Name | Credential | NPI |
|---|---|---|
| DANIEL JOSEPH BONTHIUS | MD | 1962497321 |
| USHA DAYAL | MD | 1932163516 |
| TERESITA YAP NELSON | MD | 1699739136 |
| DR. RICHARD DAVID JACOBSON | MD, PHD | 1013968858 |
| DR. LIYA BEYDERMAN | MD | 1699816017 |
| CYNTHIA FRANCIS PUDUKADAN | MD | 1487897310 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.