Wallace, Michael Jason
Wallace, Michael Jason is an individual health care provider with primary practice located at 910 Frederick Rd , Catonsville MD 21228-4516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Wallace, Michael Jason can be contacted via phone (410) 644-1880.Contact Information
Primary practice address
910 Frederick Rd
Catonsville MD 21228-4516
Phone: (410) 644-1880
Fax: (410) 646-3623
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | D0065277 | Maryland |
Profile Details
| NPI number | 1902005747 |
|---|---|
| LBN Legal business name | Wallace, Michael Jason |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2007 |
| Last updated | Apr 4th, 2022 - about 4 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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