Dwight D. Wallace, PHARMD
Dwight D. Wallace is a Pharmacist provider (Pharmacist) practicing in Aberdeen, ID, registered in the NPPES registry with NPI 1104245620 since 2014. The credential PHARMD stands for Doctor of Pharmacy.
✓ Active NPI ✓ Valid NPI checksum Sole proprietor
| NPI | 1104245620 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dwight D. Wallace |
| Credential | PHARMD |
| Sex | Male |
| Practice address | Aberdeen, ID, 83210 |
| Phone | 2083974540 |
| Enumeration date | 2014-04-11 |
| Last updated in NPPES | 2014-04-11 |
Street address withheld — NPPES sole-proprietor addresses can be home addresses. See our data policy.
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 183500000X | Pharmacist | Primary | P4895 | ID |
PHARMD — Doctor of Pharmacy: A licensed pharmacist with a professional doctorate in pharmacy. About the PHARMD credential
Copy-ready billing details
Provider: Dwight Wallace, PHARMD NPI: 1104245620 Taxonomy: 183500000X (Pharmacist) Address: Aberdeen, ID, 83210
Verify this record
Cross-check NPI 1104245620 against the authoritative CMS record: view Dwight D. Wallace on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2014-04-11.