DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. MICHAEL C. WALLIS, M.D.

Active

Urology · SALT LAKE CITY, UT

Registration Details

NPI Number
1558384388
Provider Type
Individual
Gender
Male
NPI Issued
Jul 25, 2006 (19.774163086621 yrs)
Last Updated
Dec 16, 2021
Licenses
M-13870 (ID)
6078212-1205 (UT)

Practice Information

Address
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT, 841131103
Browse UT providers · Browse ZIP 84113
Phone
8016625555
Primary Specialty
Urology
208800000X
Additional Specialty
Urology

Other Urology Providers in SALT LAKE CITY, UT

Name Credential NPI
LISA STOUT M.D. 1548263213
GARY BLAKE JOHNSON MD 1144223827
BRADLEY J. WATERMAN MD 1699718809
DR. WILLIAM O. BRANT M.D. 1467478339
MICHAEL W. MANGELSON M.D. 1114944790
STEVEN C LYNCH MD 1578677803
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.