Elizabeth Mary Wallis

M.D. | Pediatrics | Female

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Complete Profile:

Elizabeth Mary Wallis basic information including her official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics
Provider Name :	Elizabeth Mary Wallis
Credential :	M.D.
Gender :	Female

Business Address:

Elizabeth Mary Wallis address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	171 Ashley Ave Charleston, SC, 29425-8908 United States
Phone Number :	843-792-1414

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1023344025
NPI Entity Type :	Individual
First Enrolment Date :	26 Oct, 2009
Last Updated On :	14 Oct, 2020

Medicare Participation:

Elizabeth Mary Wallis participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	5496995037
Medicare Enrollment ID :	I20130702000842
Primary Specialty :	Pediatric Medicine
Medical School :	Other
Graduation Year :	2007
Accepts Medicare?	Yes. Elizabeth Mary Wallis accepts medicare insurance.

Group Practice Association:

Elizabeth Mary Wallis is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Elizabeth Mary Wallis is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
University Medical Associates	6305758574	1198	167 Ashley Ave Charleston, SC - 294258908 Ph: 8437921414	Yes
University Medical Associates	6305758574	1198	171 Ashley Ave Charleston, SC - 294258908 Ph: 8437921414	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Elizabeth Mary Wallis are as mentioned. Primary taxonomy code for Elizabeth Mary Wallis, M.D. is 208000000X (Pediatrics).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	Yes	35842	SC
208000000X	Pediatrics	No	MT190583	PA
208000000X	Pediatrics	No	MD439393	PA

Endpoints:

Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	Po Box 751461 Charlotte, NC, 28275-1461 United States
Phone Number :	843-792-6200

Business Location:

Patients can refer following map for directions to Elizabeth Mary Wallis practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.