Christine Wallace, MD

Primary specialty

Obesity Medicine (Preventive Medicine) PhysicianTaxonomy code 2083B0002X

License

35066571 Issued in OH

Practice address

8040 Princeton-Glendale Rd
Cincinnati, OH 45069-0000

Phone

(513) 246-7000

Fax

(513) 246-5479

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1841229234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 FOREST AVE STE C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123359",
            "telephone_number": "513-246-7796",
            "fax_number": "513-852-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 PRINCETON-GLENDALE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "450690000",
            "telephone_number": "513-246-7000",
            "fax_number": "513-246-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35066571",
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "OH",
            "license": "35066571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0324107",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne M. Wallace, PH.D.
• Brandon Tobias Wallace, DMD
• Chasei Wallace
• Chiquita Wallace
• Christina Wallace
• Donielle R Wallace
• Geri Wallace
• Jennifer Lynn Wallace, LPN
• John E Wallace, DPT
• Laurie A. Wallace, APRN

• Obesity Medicine (Preventive Medicine) Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Obesity Medicine (Preventive Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.