Individual
DR. MONICA L WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10810 CONNECTICUT AVENUE, KENSINGTON, MD 20895-2138
(301) 929-7507
(301) 929-7114
Mailing address
2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W, KAISER PERMANENTE MID ATL PERM MED GRP PC ATTN T BROOKS, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0055090
MD
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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