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

Stephen Russell Wallace, DO

Individual provider Diagnostic Radiology Physician · NPI 1194220061

Stephen Russell Wallace, DO is a Diagnostic Radiology in Durham, North Carolina. Qualified in 2018, 8 years ago. Practices with Sharp Rees-Stealy Medical Group Inc, a 874-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
8
Licensed in
NC
In the registry since
2018
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2301 Erwin Rd
Durham, NC 27705-4699
Phone: (919) 684-8111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 2023-00659 (NC)

Record details

NPI number1194220061
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 24, 2018
Last updated in NPPESJune 27, 2023
Certification dateJune 27, 2023
Mailing addressPo Box 63362, Charlotte, NC 28263-3362

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Sharp Rees-Stealy Medical Group Inc — 874 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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