Kimberly S Wallace Md Llc | |
1438 Defense Hwy Ste 201 Gambrills MD 21054-2021 | |
(410) 721-3200 | |
(877) 922-4349 |
Full Name | Kimberly S Wallace Md Llc |
---|---|
Speciality | Family Medicine |
Location | 1438 Defense Hwy Ste 201, Gambrills, Maryland |
Authorized Official Name and Position | Lisa Coyer (OFFICE MANAGER) |
Authorized Official Contact | 4106939648 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Kimberly S Wallace Md Llc 1438 Defense Hwy Ste 201 Gambrills MD 21054-2021 Ph: (410) 721-3400 | Kimberly S Wallace Md Llc 1438 Defense Hwy Ste 201 Gambrills MD 21054-2021 Ph: (410) 721-3200 |
NPI Number | 1790537132 |
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Provider Enumeration Date | 04/01/2024 |
Last Update Date | 04/01/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790537132 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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