| Virginia L Wallace, MD | |
|
8901 W Lincoln Avenue, West Allis, WI 53227-2477 | |
| (414) 328-7950 | |
| (414) 328-8505 |
| Full Name | Virginia L Wallace |
|---|---|
| Gender | Female |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 8901 W Lincoln Avenue, West Allis, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205861606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 41111 (Wisconsin) | Primary |
| Entity Name | Great Lakes Pathologists Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689695934 PECOS PAC ID: 7315850682 Enrollment ID: O20031112000106 |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia L Wallace, MD 8901 W Lincoln Avenue, West Allis, WI 53227-2477 Ph: (414) 328-7950 | Virginia L Wallace, MD 8901 W Lincoln Avenue, West Allis, WI 53227-2477 Ph: (414) 328-7950 |
Dr. Shanon Renee Lacy, D.O. Pathology Medicare: Accepting Medicare Assignments Practice Location: 8901 W Lincoln Ave, West Allis, WI 53227 Phone: 414-328-7675 | |
Susan Pei, Pathology Medicare: Accepting Medicare Assignments Practice Location: 8901 W Lincoln Ave, West Allis, WI 53227 Phone: 414-328-7950 | |
Dr. Wen Zhong, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 8901 W Lincoln Ave, West Allis, WI 53227 Phone: 414-328-7984 | |
Dr. Amanda Meindl, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 8901 W Lincoln Ave, West Allis, WI 53227 Phone: 414-328-7950 Fax: 414-328-8505 | |
Dr. Saad Baqai, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 8901 W Lincoln Ave, West Allis, WI 53227 Phone: 414-328-7950 Fax: 414-328-8505 | |
Patrick W. Heintz, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 8901 West Lincoln Avenue, West Allis, WI 53227 Phone: 414-328-7950 Fax: 414-328-8505 |