Michael T Wallace, MD in Fort Moore, GA - Medicare Emergency Medicine

Michael T Wallace, MD is a medicare enrolled "Emergency Medicine" physician in Fort Moore, Georgia. His current practice location is 6600 Van Aalst Blvd Bldg 9250, Fort Moore, Georgia. You can reach out to his office (for appointments etc.) via phone at (762) 408-2604.

Michael T Wallace is licensed to practice in Georgia (license number 12643) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427624170.

Contact Information

	Michael T Wallace, MD
	6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102
	(762) 408-2604
	Not Available

Map and Direction

Physician's Profile

Full Name	Michael T Wallace
Gender	Male
Speciality	Emergency Medicine
Location	6600 Van Aalst Blvd Bldg 9250, Fort Moore, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427624170
Provider Enumeration Date: 06/02/2021
Last Update Date: 08/02/2024

Medicare PECOS Information:

PECOS PAC ID: 3678976271
Enrollment ID: I20210720002185

Medical Identifiers

Medical identifiers for Michael T Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427624170	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	12643 (Georgia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael T Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Michael T Wallace, MD 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102 Ph: (262) 506-8990	Michael T Wallace, MD 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102 Ph: (762) 408-2604

Reviews and Comments

Emergency Medicine Doctors in Fort Moore, GA

Dr. Antonio Ziherl, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6600 Van Aalst Blvd, Fort Moore, GA 31905 Phone: 762-408-2604
Dr. Joseph Robert Griggs, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6600 Van Aalst Blvd, Fort Moore, GA 31905 Phone: 762-408-2273

Michael T Wallace, MD - Medicare Emergency Medicine in Fort Moore, GA