Individual
DR. MARK ALLEN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
15 ANCHOR DR STE 102, ROCKPORT, ME 04856-3847
(207) 301-3660
(207) 301-5160
Mailing address
15 ANCHOR DR STE 102, ROCKPORT, ME 04856-3847
(207) 301-3660
(207) 301-5160
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
DO3910
ME
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
DO3910
ME
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
5101015234
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
DO3910
ME
Other
Enumeration date
07/27/2007
Last updated
01/29/2026
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