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
Fax: (410) 646-3623
Website:

Health care specialties

SpecialtyCodeLicense #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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