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

Dr. Colleen Maire Wallace, MD

Individual provider Pediatrics Physician · NPI 1194743815

Dr. Colleen Maire Wallace, MD is a Pediatrics Physician in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
Specialties on file
3
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

1 Childrens Pl Div Ped Hospitalist Med
Saint Louis, MO 63110-1002
Phone: (314) 454-2076
Fax: (314) 747-8953
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Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence 2004002778 (MO)
Pediatrics Physician Taxonomy 208000000X · Licence 2004002778 (MO)
Pediatric Emergency Medicine (Pediatrics) Physician Taxonomy 2080P0204X · Licence 2004002778 (MO)

Record details

NPI number1194743815
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 18, 2006
Last updated in NPPESApril 17, 2025

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