Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimberly S Wallace MD LLC

Organization Family Medicine Physician · NPI 1790537132

Kimberly S Wallace MD LLC is a Family Medicine Physician in Gambrills, Maryland. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1438 Defense Hwy Ste 201
Gambrills, MD 21054-2021
Phone: (410) 721-3200
Fax: (877) 922-4349
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1790537132
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Coyer — Office Manager · (410) 693-9648
NPI enumeratedApril 1, 2024
Last updated in NPPESApril 1, 2024
Certification dateApril 1, 2024
Mailing address1438 Defense Hwy Ste 201, Gambrills, MD 21054-2021

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