Individual
DR. ELRON J WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 787-4656
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D65067
MD
207L00000X
Anesthesiology Physician
MD428013
PA
Other
Enumeration date
09/12/2006
Last updated
01/09/2024
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