Wallace, Marcus
Wallace, Marcus is an individual health care provider with primary practice located at 15790 Paul Vega Md Dr Hospital Medicine, Hammond LA 70403-1434. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Wallace, Marcus can be contacted via phone (985) 230-3066.Contact Information
Primary practice address
15790 Paul Vega Md Dr Hospital Medicine
Hammond LA 70403-1434
Phone: (985) 230-3066
Fax: (985) 230-2072
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35540 | Arizona |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD.025294 | Louisiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD.025294 | Louisiana |
Profile Details
| NPI number | 1841201860 |
|---|---|
| LBN Legal business name | Wallace, Marcus |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 11th, 2006 |
| Last updated | Feb 19th, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841201860 | NPPES |
| Arizona | MEDICAID | 143374-01 |
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