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
Fax: (410) 721-2680
Website:

Health care specialties

SpecialtyCodeLicense #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 6 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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