Individual
DR. PATRICK WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-3300
Mailing address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-3300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
H0091578
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2018
Last updated
06/28/2021
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