Wallace, Kimberly Shannon
Wallace, Kimberly Shannon is an sole proprietor health care provider with primary practice located at 1438 Defense Hwy Suite 201 , Gambrills MD 21054. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wallace, Kimberly Shannon can be contacted via phone (410) 721-3200.Contact Information
Primary practice address
1438 Defense Hwy Suite 201
Gambrills MD 21054
Phone: (410) 721-3200
Fax: (410) 721-2680
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D66924 | Maryland |
Profile Details
| NPI number | 1770627705 |
|---|---|
| LBN Legal business name | Wallace, Kimberly Shannon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Mar 18th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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