Individual
WALLACE OBENSHAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
251 S BOHEMIA AVE, CECILTON, MD 21913-0670
(410) 275-8157
(410) 275-9919
Mailing address
PO BOX 190, ELKTON, MD 21922-0190
(410) 398-4679
(410) 620-3686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0035779
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080176795
MEDICARE RAILROAD
MD
05
—
168491400
—
MD
Enumeration date
05/04/2006
Last updated
07/06/2012
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