Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark E Wallace, MD

Individual provider Family Medicine Physician · NPI 1083603088

Mark E Wallace, MD is a Family Medicine Physician in Greeley, Colorado. Licensed in California and Colorado. Registered with an NPI since 2005.

Licensed in
CA, CO
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1600 23rd Ave
Greeley, CO 80634-6070
Phone: (970) 356-2424
Fax: (970) 346-2774
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence DR32010 (CO)
Family Medicine Physician Taxonomy 207Q00000X · Licence G056273 (CA)

Record details

NPI number1083603088
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 21, 2005
Last updated in NPPESDecember 20, 2010

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