| Stephanie Louise Wallace, | |
|
6701 N Charles St Ste 4226, Towson, MD 21204-6808 | |
| (410) 296-4616 | |
| (410) 337-5068 |
| Full Name | Stephanie Louise Wallace |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 16 Years |
| Location | 6701 N Charles St Ste 4226, Towson, Maryland |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518299197 | NPI | - | NPPES |
| 570079500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R160036 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Greater Baltimore Medical Center | Baltimore, MD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gbmc Hospital Based Services Llc | 6002299369 | 47 |
| Entity Name | Johns Hopkins University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922008549 PECOS PAC ID: 8921903147 Enrollment ID: O20031215000719 |
| Entity Name | Anesthesia Company Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871548156 PECOS PAC ID: 4587559026 Enrollment ID: O20040216000401 |
| Entity Name | North American Partners In Anesthesia Maryland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093707879 PECOS PAC ID: 1850283144 Enrollment ID: O20040330000405 |
| Entity Name | First Colonies Anesthesia Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740218767 PECOS PAC ID: 8426039744 Enrollment ID: O20040525000119 |
| Entity Name | Lifebridge Community Gastroenterology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033558416 PECOS PAC ID: 7618108119 Enrollment ID: O20140326001773 |
| Entity Name | North Calvert Anesthesiology Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710360227 PECOS PAC ID: 8921309980 Enrollment ID: O20151216000559 |
| Entity Name | Gbmc Hospital Based Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730824400 PECOS PAC ID: 6002299369 Enrollment ID: O20220818002500 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Louise Wallace, 1122 Kenilworth Dr Ste 317, Baltimore, MD 21204-2146 Ph: (410) 296-4616 | Stephanie Louise Wallace, 6701 N Charles St Ste 4226, Towson, MD 21204-6808 Ph: (410) 296-4616 |
Monika Harold, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 443-849-3880 | |
Terri Bonsall, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 410-296-4616 Fax: 410-337-5068 | |
Rita Kesselman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7601 Osler Dr, Towson, MD 21204 Phone: 410-337-4501 | |
Tim Ngoc Dinh, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6701 N Charles St Ste 4226, Towson, MD 21204 Phone: 410-296-4616 Fax: 410-337-5068 | |
Thomas Curry, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 410-296-4616 Fax: 410-337-5068 | |
Barbara Rogers, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1122 Kenilworth Dr, Suite 317, Towson, MD 21204 Phone: 410-296-4616 Fax: 410-337-5068 | |
Francis Equale, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 410-296-4616 Fax: 410-337-5068 |