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

Individual provider Family Medicine Physician · NPI 1265902092

Gregory Stephen Wallace, MD is a Family Medicine Physician in Atlanta, Georgia. Practices as a sole proprietor. Licensed in California and Georgia.

Licensed in
CA, GA
In the registry since
2018
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

1042 Mason Woods Dr NE
Atlanta, GA 30329-3802
Phone: (678) 974-7424
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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 051099 (GA)
Family Medicine Physician Taxonomy 207Q00000X · Licence G81645 (CA)

Record details

NPI number1265902092
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedDecember 5, 2018
Last updated in NPPESDecember 5, 2018
Mailing address1042 Mason Woods Dr Ne, Atlanta, GA 30329-3802

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