Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MAXWELL WALLACE, M.D.
ActiveDR. MAXWELL WALLACE, M.D. is a Neurology with Special Qualifications in Child Neurology healthcare provider located in SAINT LOUIS, Missouri. NPI 1588195267 is currently active in the NPPES registry. Verify at CMS.
Neurology with Special Qualifications in Child Neurology · SAINT LOUIS, MO
Registration Details
- NPI Number
- 1588195267
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 23, 2017 (9.4420032452876 yrs)
- Last Updated
- Aug 22, 2022
- License
-
2022027207 (MO)
Practice Information
- Address
-
1465 S GRAND BLVDRM 2717SAINT LOUIS, MO, 631041003Browse MO providers · Browse ZIP 63104
- Phone
- 3145775634
- Fax
- 3145775616
- Primary Specialty
-
Neurology with Special Qualifications in Child Neurology
2084N0402X
Other Neurology with Special Qualifications in Child Neurology Providers in SAINT LOUIS, MO
| Name | Credential | NPI |
|---|---|---|
| DR. STEVEN MARK ROTHMAN | MD | 1972534485 |
| DR. CHRISTOPHER DANIEL SMYSER | MD | 1043235245 |
| DR. WILLIAM EDWIN DODSON | MD | 1275559593 |
| DR. DAVID JOHN HINKLE | M.D. | 1235155136 |
| GLEN FENTON | — | 1144246091 |
| DR. JEFFREY JOSEPH NEIL | MD | 1699793158 |
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.