Kimberly Shannon Wallace in Gambrills - Family Medicine
Kimberly Shannon Wallace - NPI 1770627705
Kimberly Shannon Wallace is a Family Medicine in Gambrills, Maryland. Kimberly Shannon Wallace practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Kimberly Shannon Wallace is 1770627705. The last update date is 2019-03-18.
Kimberly Shannon Wallace's current location address is 1438 Defense Hwy Suite 201, Gambrills, Maryland. You can contact this provider via phone number 4107213200 and fax number 4107212680. The mailing address for Kimberly Shannon Wallace is 1438 Defense Hwy Suite 201, Gambrills, Maryland. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kimberly Shannon Wallace |
|---|---|
| Address | 1438 Defense Hwy Suite 201, Gambrills, Maryland |
| Phone Number | 4107213200 |
| Fax Number | 4107212680 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1770627705 |
|---|---|
| Provider Enumeration Date | 2007-02-15 |
| Last Updated Date | 2019-03-18 |
Provider Mailing Address Detail
| Address | 1438 Defense Hwy Suite 201 |
|---|---|
| City | Gambrills |
| State | Maryland (MD) |
| Post Code | 21054 |
| Phone Number | 4107213200 |
| Fax Number | 4107212680 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | D66924 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Kimberly Shannon Wallace by the Centers for Medicare & Medicaid Services?
The Kimberly Shannon Wallace has been issued the NPI (National Provider Identifier) 1770627705 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Kimberly Shannon Wallace is physically located?
The Kimberly Shannon Wallace is physically situated at the following address: 1438 Defense Hwy Suite 201, Gambrills, MD, 21054.
What is Kimberly Shannon Wallace's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Kimberly Shannon Wallace is Family Medicine, and the taxonomy code that categorizes this field of expertise is 207Q00000X.
On what date did the Kimberly Shannon Wallace receive its 1770627705 assignment from the Centers for Medicare & Medicaid Services?
The Kimberly Shannon Wallace was assigned its 1770627705 by the Centers for Medicare & Medicaid Services on 2007-02-15.
When was the information related to Kimberly Shannon Wallace most recently updated or refreshed?
The details pertaining to the Kimberly Shannon Wallace, including its address, specialty, and other relevant information, were last updated or refreshed on 2019-03-18.