Shannon Leigh Wallace
Female Pelvic Medicine and Reconstructive Surgeon
Cleveland Clinic 9500 Euclid Avenue
Cleveland
, Ohio 44195-1705
Shannon Leigh Wallace
Female Pelvic Medicine and Reconstructive Surgeon
Cleveland Clinic 9500 Euclid Avenue
Cleveland
, Ohio 44195-1705
(303) 880-7809
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About
Features
Specialties
- Female Pelvic Medicine and Reconstructive Surgeon
Languages spoken
- English
Location
First Address
- Shannon Leigh Wallace
- 1470 Franks Ln
- Menlo Park, CA
- Zip : 94025-5960
- Phone : (303) 880-7809
Second Address
- Shannon Leigh Wallace
- Cleveland Clinic 9500 Euclid Avenue
- Cleveland, OH
- Zip : 44195-1705
- Phone : (216) 636-8926
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A149644 | CA |
National Provider Identifier
| NPI | 1205102092 |
|---|---|
| Provider Name | Shannon Leigh Wallace |
| First Address | Menlo Park, CA 94025-5960 |
| Second Address | Cleveland, OH 44195-1705 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/03/2012 |
| Last Update Date | 10/03/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.