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Contact Information

DAVID A WALLACE, DO
11100 EUCLID AVE
CLEVELAND, OH44106-1716
 Phone: 216-844-7330
 Fax: 216-844-3781
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Addiction Medicine

207LA0401X 05 Physician/Anesthesiology
 

Critical Care Medicine

207LC0200X 05 Physician/Anesthesiology
 

Hospice and Palliative Medicine

207LH0002X 05 Physician/Anesthesiology
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Pediatric Anesthesiology

207LP3000X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for DAVID A WALLACE · (Male)

NPI # 1508880303
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/26/2006
Last updated 08/19/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 34-005216
  • OH Medicaid 0856622
  • OH Other 5792078 AETNA
  • OH Other 000000516017 ANTHEM
  • OH Other 0583328 BCMH
  • OH Other 751023 BUCKEYE MEDICAID
  • OH Other P00412647 MEDICARE RAILROAD
  • OH Other 50060854 RAILROAD MEDICARE
  • OH Other 000000221259 UNISON
  • OH Other 364105 WELLCARE MEDICAID
Hospital affiliation(s)
  • METROHEALTH SYSTEM - (Acute Care)
    2500 METROHEALTH DRIVE
    CLEVELAND, OH 44109
  • UNIVERSITY HOSPITALS OF CLEVELAND - (Acute Care)
    11100 EUCLID AVENUE
    CLEVELAND, OH 44106
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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