Brian C Wallace (NPI# 1801864350, PAC ID# 5698961977) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1801864350 |
| PAC ID by PECOS | 5698961977 |
| Professional Enrollment ID | I20101129000752 |
| Full Name | Brian C Wallace |
| Address |
9005 Kilbride Rd Baltimore MD 21236-2017 |
| Phone Number | 4439046999 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1981 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | GERIATRIC MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210056 | MEDSTAR GOOD SAMARITAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 9005 Kilbride Rd, Baltimore, MD 21236-2017 | 4439046999 |
| Street Address |
9005 KILBRIDE RD |
| City | BALTIMORE |
| State | MD |
| Zip | 21236-2017 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Camille B Madison | Emergency Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Erin E Derenick | Physical Therapy | Gold Medal Physical Therapy LLC | 9634 Bel Air Rd, Perry Hall, MD 21236 |
| Andrew Davis | Psychiatry | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Alyssa M Mathew | Internal Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Kiersten E Kilczewski | Physical Therapy | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Tamischer B Nettles | Family Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Meeta Gulati | Internal Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Jenaro John Hernandez | Internal Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Julian Barkan | Emergency Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Jamille Patrice Taylor | Emergency Medicine | Kaiser Foundation Health Plan of The Mid-atlantic States Inc | 4920 Campbell Rd, White Marsh, MD 21236 |
| Find all physicians in zip 21236 | |||
| City | BALTIMORE |
| Zip Code | 21236 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | BALTIMORE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Brian C Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.