Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KIMBERLY SHANNON WALLACE, MD
Active Sole ProprietorKIMBERLY SHANNON WALLACE, MD is a Family Medicine healthcare provider located in GAMBRILLS, Maryland. NPI 1770627705 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · GAMBRILLS, MD
Registration Details
- NPI Number
- 1770627705
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 15, 2007 (19.448846608977 yrs)
- Last Updated
- Mar 18, 2019
- License
-
D66924 (MD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1438 DEFENSE HWY SUITE 201GAMBRILLS, MD, 21054Browse MD providers · Browse ZIP 21054
- Phone
- 4107213200
- Fax
- 4107212680
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in GAMBRILLS, MD
| Name | Credential | NPI |
|---|---|---|
| DR. DAVID CONRAD ANDERSON | M.D. | 1508866336 |
| DR. DAVID G FREAS | MD | 1497748800 |
| DR. IAN M SHANTZ | MD | 1083607410 |
| TARA THURLBY MUSCOVICH | MD | 1619924263 |
| PETER SU | MD | 1184664146 |
| HOWARD KENNETH SCHULTZ JR. | MD | 1164450920 |
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.