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Contact Information

MATHEW C WALLACE, MD
4228 LOMAC ST STE 2
MONTGOMERY, AL36106-2929
 Phone: 919-928-2351
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2084P2900X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for MATHEW C WALLACE · (Male)

NPI # 1306945829
Status Active
Credentials MD
Entity Individual
Enumeration date 09/21/2006
Last updated 08/01/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • AL License # MD.29202
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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