Dr Andrew Blake Wallace, MD | |
510 S Kingshighway Blvd, Mallinckrodt Institue Of Radiology, Saint Louis, MO 63110-1016 | |
(314) 362-2978 | |
Not Available |
Full Name | Dr Andrew Blake Wallace |
---|---|
Gender | Male |
Speciality | Diagnostic Radiology |
Experience | 11 Years |
Location | 510 S Kingshighway Blvd, Saint Louis, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740626654 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 2020-04583 (North Carolina) | Primary |
2085R0202X | Radiology - Diagnostic Radiology | 2014013932 (Missouri) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
New Hanover Regional Medical Center | Wilmington, NC | Hospital |
Novant Health Brunswick Medical Center | Supply, NC | Hospital |
J Arthur Dosher Memorial Hospital | Southport, NC | Hospital |
Pender Memorial Hospital | Burgaw, NC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Delaney Radiologists Group Pllc | 4981684875 | 46 |
Wilmington Health Pllc | 6103722509 | 286 |
Delaney Radiologists Pa | 6305813684 | 46 |
Entity Name | Wilmington Health Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881632339 PECOS PAC ID: 6103722509 Enrollment ID: O20031208000800 |
Entity Name | Delaney Radiologists Group Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912982166 PECOS PAC ID: 4981684875 Enrollment ID: O20040721001496 |
Entity Name | Delaney Radiologists Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902881147 PECOS PAC ID: 6305813684 Enrollment ID: O20040915000814 |
Entity Name | Diagnostic Imaging Partners |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679025522 PECOS PAC ID: 8820374069 Enrollment ID: O20170424001606 |
Mailing Address | Practice Location Address |
---|---|
Dr Andrew Blake Wallace, MD 1025 Medical Center Dr, Wilmington, NC 28401-7354 Ph: (910) 762-3882 | Dr Andrew Blake Wallace, MD 510 S Kingshighway Blvd, Mallinckrodt Institue Of Radiology, Saint Louis, MO 63110-1016 Ph: (314) 362-2978 |
Dr. Hilton I Price, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 11133 Dunn Rd, Dept Radiology, Saint Louis, MO 63136 Phone: 314-362-7200 Fax: 314-747-4189 | |
Benjamin Lee, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 510 S Kingshighway Blvd, Saint Louis, MO 63110 Phone: 314-362-7092 | |
Dr. Kyle Anthony O'blanc, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1825 High Oak Rd, Saint Louis, MO 63131 Phone: 504-710-8234 | |
Dr. Michael D. Bazzani, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 10010 Kennerly Rd, Saint Louis, MO 63128 Phone: 314-525-1165 Fax: 314-525-1485 | |
Chelsea Schmitt, Radiology Medicare: Medicare Enrolled Practice Location: 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110 Phone: 314-362-2819 | |
Dr. James Edward Kelly, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 510 S Kingshighway Blvd, Dept Radiology, Saint Louis, MO 63110 Phone: 314-362-7200 Fax: 314-747-4189 | |
Cindy Xin Zhang, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 615 S New Ballas Rd, Dept Of Radiology, Saint Louis, MO 63141 Phone: 314-251-6031 Fax: 314-251-6343 |