IndividualActive
Michael Wallis, M.D.
NPI 1558384388 · Urology Physician · Salt Lake City, UT
Provider details
- NPI number
- 1558384388
- Entity type
- Individual
- Primary specialty
- Urology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- M-13870 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone: (801) 662-5555
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 413035
Salt Lake City, UT 84141-3035
Registry dates
- Enumerated
- 2006-07-25
- Last updated
- 2021-12-16
- Certified
- 2021-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.