Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRENDAN WALLACE, MD
Active Sole ProprietorBRENDAN WALLACE, MD is a Urology healthcare provider located in BANGOR, Maine. NPI 1164159257 is currently active in the NPPES registry. Verify at CMS.
Urology · BANGOR, ME
Registration Details
- NPI Number
- 1164159257
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 8, 2022 (4.0349256246882 yrs)
- Last Updated
- Aug 8, 2022
- License
-
MD25666 (ME)
- Sole Proprietor
- Yes
Practice Information
- Address
-
55 BROADWAYBANGOR, ME, 044015201Browse ME providers · Browse ZIP 04401
- Phone
- 2079470469
- Primary Specialty
-
Urology
208800000X
Other Urology Providers in BANGOR, ME
| Name | Credential | NPI |
|---|---|---|
| DR. ALI KHAVARI | M.D. | 1013913433 |
| DR. JONAS GRICIUS | M.D. | 1659534782 |
| CURTIS P. ROSS | D.O. | 1063640555 |
| MARISA CHRISTINE GRAY | MD | 1629423520 |
| KAITLYN RULLO | — | 1295465409 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.