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Individual

DR. ERIC WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7187 WOODMONT AVE, BETHESDA, MD 20815-6208
(888) 663-6331
Mailing address
1 EMBARCADERO CTR STE 1900, SAN FRANCISCO, CA 94111-3723
(415) 658-6791
(415) 252-7176

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
243033
MA
207Q00000X
Family Medicine Physician
Primary
D0100827
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-2297845
UNITED HEALTH CARE
01
042297845
MULTI-PLAN
MA
01
042297845
HCVM
01
1154434488
TMP
MA
01
1154434488
TUFTS HEALTH PLAN
05
1154434488
MA
01
3748610
CIGNA
MA
01
7087919
AETNA
MA
01
AA387771
HARVARD PILGRIM
MA
01
SS0165
BCBSMA
MA
Enumeration date
08/17/2006
Last updated
02/17/2026
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