Dr. Douglas McKay Wallace, MD
Psychiatry & Neurology, Neurology in Miami, FL. Individual provider (NPI-1).
NPI number1013058932
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1013058932
- Entity type
- Individual (NPI-1)
- Name
- Dr. Douglas McKay Wallace
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 12, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NEUROLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | ME94643 | FL | Yes |
Practice location
1201 Nw 16th StMiami Va Medical Center, Dept Of Neurology
Miami, FL 33125-1624
Phone 305-575-7000
Mailing address
11104 Sw 139th CtMiami, FL 33186-3251
Phone 305-387-7346 · Fax 305-387-4632
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