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Deactivated NPI 1417996232 Deactivated / Inactive NPI Male Practitioner

Dr. David Lee Wallace , MD

Internal Medicine • Marion, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. David Wallace has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 06, 2006
NPI Deactivation Date March 06, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. David Wallace, MD was a registered Internal Medicine practicing in Marion, IN. Throughout an active medical career spanning 19 years, Dr. Wallace provided care at the practice location at 441 N WABASH AVE until profile deactivation on 2025-03-06.

Practice Location & Contact Primary Location

Practice Address

441 N Wabash Ave

Marion, IN 469522612

Telephone 7656607600
Fax 7656517313
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Marion, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.6 Yrs
State Avg: 26.2 Yrs
Regional Practice Density
14 Specialists

Practicing in Marion, IN (2204 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License IN 01027186

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1104828334

Doctor of Medicine (M.D.)

Gladys Black , APRN

Nurse Practitioner - Acute Care

NPI 1205011715

Advanced Practice Registered Nurse

NPI 1285636415

Doctor of Medicine (M.D.)

Jeremy Hawk , NP

Nurse Practitioner

NPI 1508011081

Nurse Practitioner

Alvin Brown , NP

Nurse Practitioner

NPI 1568573145

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 06, 2025

Record deactivated on March 06, 2025

NPI Profile Active October 19, 2012

NPI status registered as active in NPPES database

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Updated Practice Location October 19, 2012

Registered at 441 N WABASH AVE, MARION, IN 469522612 (Tel: 7656607600)

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Updated Business Mailing Address October 19, 2012

Registered at 330 NORTH WABASH AVE., SUITE G20, MARION, IN 469522600 (Tel: 7656606411)

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Provider Name / Credentials Updated October 19, 2012

Recorded as DAVID WALLACE, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 19, 2012

Internal Medicine (License #01027186 in IN)

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Initial NPI Registration & Enumeration June 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417996232
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 06, 2006
Last Update: October 19, 2012
Deactivation Date: March 06, 2025

Mailing Address

330 North Wabash Ave., Suite G20

Marion, IN 469522600

Phone: 7656606411

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.