Wallen, Reginald M

Wallen, Reginald M is an individual health care provider with primary practice located at 6104 Old Branch Avenue Kaiser Permanente, Ppqa, 6 West, Attn Theresa Brooks, Temple Hills MD 20748-2518. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wallen, Reginald M can be contacted via phone (301) 702-6100.

Contact Information

Primary practice address
6104 Old Branch Avenue Kaiser Permanente, Ppqa, 6 West, Attn Theresa Brooks Temple Hills MD 20748-2518
Phone: (301) 702-6100
Fax: (301) 702-6367
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D35317 Maryland
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101044800 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD16350 District of Columbia

Profile Details

NPI number 1225194210
LBN Legal business name Wallen, Reginald M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Jul 8th, 2007 - about 17 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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