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

Dr. Lacie Victoria Wallace, MD

Individual provider Family Medicine Physician · NPI 1366018012

Dr. Lacie Victoria Wallace, MD is a Family Practice in Mt Pleasant, South Carolina. Graduated from Brody School of Medicine at East Carolina University in 2021, 5 years ago. Practices with Roper Saint Francis Physicians Network, a 532-clinician group, accepts Medicare assignment and offers telehealth. Licensed in South Carolina.

Years since qualifying
5
Trained at
Brody School of Medicine at East Carolina University
Licensed in
SC
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1400 Hospital Dr
Mt Pleasant, SC 29464-3255
Phone: (843) 884-1341
Fax: (843) 884-1345
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 86050 (SC)
Family Medicine Physician Taxonomy 207Q00000X · Licence LL86050 (SC)

Record details

NPI number1366018012
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 2, 2021
Last updated in NPPESSeptember 11, 2024
Certification dateSeptember 11, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolBRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduated 2021 (5 years in practice)
Group practice Roper Saint Francis Physicians Network — 532 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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