Thomas, Wallace
Thomas, Wallace is an sole proprietor health care provider with primary practice located at 305 Memorial Medical Pkwy Ste 307 , Daytona Beach FL 32117-5169. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Thomas, Wallace can be contacted via phone (386) 231-4351.Contact Information
Primary practice address
305 Memorial Medical Pkwy Ste 307
Daytona Beach FL 32117-5169
Phone: (386) 231-4351
Fax: (386) 231-3517
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 308521 | New York |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME126338 | Florida |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME126338 | Florida |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME126338 | Alabama |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | ME126338 | Florida |
Profile Details
| NPI number | 1831490432 |
|---|---|
| LBN Legal business name | Thomas, Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 12th, 2010 |
| Last updated | Aug 6th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831490432 | NPPES |
| Florida | MEDICAID | 018564000 |
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