Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK ALLEN WALLACE, D.O.
ActiveDR. MARK ALLEN WALLACE, D.O. is a Facial Plastic Surgery healthcare provider located in ROCKPORT, Maine. NPI 1952591828 is currently active in the NPPES registry. Verify at CMS.
Facial Plastic Surgery · ROCKPORT, ME
Registration Details
- NPI Number
- 1952591828
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 27, 2007 (19.029580022331 yrs)
- Last Updated
- Jan 29, 2026
- Licenses
-
5101015234 (MI)DO3910 (ME)DO3910 (ME)
Practice Information
- Address
-
15 ANCHOR DR STE 102ROCKPORT, ME, 048563847Browse ME providers · Browse ZIP 04856
- Phone
- 2073013660
- Fax
- 2073015160
- Primary Specialty
-
Facial Plastic Surgery
207YX0905X
- Additional Specialty
- Otolaryngology
- Additional Specialty
- Facial Plastic Surgery
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.