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1770627705
KIMBERLY SHANNON WALLACE
GAMBRILLS, MD
NPI
1770627705
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MD D66924)
Enumeration Date
2007-02-15
Last Update Date
2019-03-18
Business Address
KIMBERLY SHANNON WALLACE MD
1438 DEFENSE HWY SUITE 201
GAMBRILLS, MD 21054
Phone number: 410-721-3200
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Mailing Address
KIMBERLY SHANNON WALLACE MD
1438 DEFENSE HWY SUITE 201
GAMBRILLS, MD 21054
Phone number: 410-721-3200
Copy
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