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

Marshall W. Wallace, MD

Individual provider Surgery Physician · NPI 1154024974

Marshall W. Wallace, MD is a Surgery Physician in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2023.

Licensed in
UT
In the registry since
2023
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

30 N Mario Capecchi Dr Rm 4S100
Salt Lake City, UT 84112-0002
Phone: (801) 581-2121
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 14168058-1205 (UT)

Record details

NPI number1154024974
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2023
Last updated in NPPESOctober 1, 2024
Certification dateSeptember 27, 2024

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