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

Michael Anthony Wallace, IDC

Individual provider Independent Duty Corpsman · NPI 1427216837

Michael Anthony Wallace, IDC is an Independent Duty Corpsman in Portsmouth, Virginia. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone: (757) 953-6505
Show map & directions

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

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1427216837
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedJune 2, 2008
Last updated in NPPESJune 23, 2011
Mailing address620 John Paul Jones Cir, Portsmouth, VA 23708-2111

Other providers in Portsmouth