DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR. DANIEL LELAND WALLACE DO

MEDICARE: DR. DANIEL LELAND WALLACE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician5101011648MI

General Provider Information

NPI Number : 1275525875
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL LELAND WALLACE DO
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC-845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number : 616-267-0800
Fax Number : 616-267-0801
Provider Business Practice Location Address
First Line : 275 MICHIGAN ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2531
Country : US
Telephone Number : 616-267-0800
Fax Number : 616-267-0801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 01/22/2025

Similar Medicare Providers

1194383380 — DR. LUKE ROBERT SALBERT MD
Practice Location Address:
275 MICHIGAN ST NE
GRAND RAPIDS, MI
49503-2531
Practice Phone: 616-267-7900
Practice Fax: 616-267-7901
1881940716 — DR. NICOLE LUCIA TALLEY MD
Practice Location Address:
275 MICHIGAN ST NE
GRAND RAPIDS, MI
49503-2531
Practice Phone: 616-391-8810
Practice Fax:
1770576977 — TODD W VITAZ MD
Practice Location Address:
275 MICHIGAN ST NE
GRAND RAPIDS, MI
49503-2531
Practice Phone: 616-267-7900
Practice Fax: 616-267-7901
1447230107 — CHERYL J KUZ MD
Practice Location Address:
275 MICHIGAN ST NE
GRAND RAPIDS, MI
49503-2531
Practice Phone: 616-391-8810
Practice Fax: 616-391-8897
1407820590 — BERNARD HENRY EISENGA M.D.
Practice Location Address:
275 MICHIGAN ST NE
GRAND RAPIDS, MI
49503-2531
Practice Phone: 616-391-3777
Practice Fax: 616-391-3755
1942277348 — CARLOS TAVERA MD
Practice Location Address:
275 MICHIGAN ST NE
GRAND RAPIDS, MI
49503-2531
Practice Phone: 616-391-3777
Practice Fax: 616-391-3755

Directions to “ DR. DANIEL LELAND WALLACE DO” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.