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

Margot Wallace

Individual provider Physician Assistant · NPI 1578176863

Margot Wallace is a Physician Assistant in Randallstown, Maryland. Qualified in 2020, 6 years ago. Practices with Lifebridge Community Physicians Inc, a 185-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020

Practice location Address checks out

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone: (410) 521-2200
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1578176863
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 26, 2020
Last updated in NPPESAugust 26, 2020
Certification dateAugust 26, 2020
Mailing address936 Creek Park Rd, Bel Air, MD 21014-2324

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Lifebridge Community Physicians Inc — 185 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Randallstown