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

Weldon Wallace, MD

Individual provider Family Medicine Physician · NPI 1679550875

Weldon Wallace, MD is a Family Medicine Physician in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2005.

Licensed in
MI
In the registry since
2005
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

1260 Ekhart St NE
Grand Rapids, MI 49503-1372
Phone: (616) 356-5202
Fax: (616) 458-9845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4301085136 (MI)

Record details

NPI number1679550875
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 28, 2005
Last updated in NPPESJuly 13, 2026
Mailing address1260 Ekhart St Ne, 112, Grand Rapids, MI 49503-1372

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