Search › Michigan › 207Q00000X
Weldon Wallace, MD
NPI 1679550875 · on the registry since 2005
Practice
- Address
- 1260 Ekhart St Ne
Grand Rapids, MI 49503 - Phone
- (616) 356-5202
- Fax
- (616) 458-9845
- Clinicians at this address
- 57
Additional practice sites
- Po Box 740013, Atlanta, GA
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 207Q00000X
- Licence states on file
- MI, SC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-08-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan