Individual
SHAWN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4400 STAMP RD STE 404A, TEMPLE HILLS, MD 20748-6730
(301) 664-2149
Mailing address
4400 STAMP RD STE 404A, TEMPLE HILLS, MD 20748-6730
(301) 664-2149
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
—
—
Other
Enumeration date
01/02/2023
Last updated
01/02/2023
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