Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
COLLEEN MICHELLE WALLACE, M.D.
Active Sole ProprietorCOLLEEN MICHELLE WALLACE, M.D. is a Pediatrics healthcare provider located in LAUREL, Maryland. NPI 1255627469 is currently active in the NPPES registry. Verify at CMS.
Pediatrics · LAUREL, MD
Registration Details
- NPI Number
- 1255627469
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 26, 2011 (15.17447481793 yrs)
- Last Updated
- Jan 15, 2025
- Licenses
-
D78050 (MD)D78050 (MD)0116023955 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
14113 BALTIMORE AVE STE BLAUREL, MD, 207075073Browse MD providers · Browse ZIP 20707
- Phone
- 2403605723
- Primary Specialty
-
Pediatrics
208000000X
- Additional Specialty
- Pediatrics
- Additional Specialty
- Pediatrics
Other Pediatrics Providers in LAUREL, MD
| Name | Credential | NPI |
|---|---|---|
| HELMY QURTOM | MD | 1659367787 |
| DR. GABRIEL O. OBIADI | M.D. | 1649267352 |
| DR. LOUIS BLAND | M.D. | 1265412043 |
| INAS ANDERSON | M.D. | 1649250325 |
| DR. MEI-LIN LU | M.D. | 1114907896 |
| ANN WERNER | M.D. | 1588644090 |
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.