IndividualActive
Gonzalo Wallis, MD
NPI 1417179078 · Pediatric Cardiology Physician · Charlotte, NC
Provider details
- NPI number
- 1417179078
- Entity type
- Individual
- Primary specialty
- Pediatric Cardiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 2013-02269 (NC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1001 Blythe Blvd
Ste 500
Charlotte, NC 28203-5866
Phone: (704) 373-1813
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 19305
Charlotte, NC 28219-9305
Additional practice locations (4)
- 100 Medical Park DrSte 310Concord, NC 28025-2948Phone: (704) 403-2860
- 1781 Tate Blvd SeSte 203Hickory, NC 28602-4251Phone: (704) 381-3970
- 1550 Faulk StSte 3100Monroe, NC 28112-5086Phone: (704) 667-3410
- 134 Medical Park RdSte 111 - Adult CardiologyMooresville, NC 28117-8526Phone: (704) 801-9100
Registry dates
- Enumerated
- 2007-05-03
- Last updated
- 2024-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.