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

Individual provider Psychiatry Physician · NPI 1265991335

Dr. Paul Michael Wallace, MD is a Psychiatry in Providence, Rhode Island. Qualified in 2019, 7 years ago. Practices with The Providence Center Inc, a 43-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
7
Licensed in
RI
In the registry since
2019
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

528 N Main St
Providence, RI 02904
Phone: (401) 528-0123
Fax: (401) 528-0124
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 530 N Main St, Providence, RI 02904-5762 — (401) 274-2500

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence MD19363 (RI)

Record details

NPI number1265991335
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 18, 2019
Last updated in NPPESDecember 18, 2025
Certification dateDecember 18, 2025
Mailing address528 N Main St Unit 4, Providence, RI 02904-5770

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice The Providence Center Inc — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Providence