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

Michael T Wallace, MD

Individual provider Emergency Medicine Physician · NPI 1427624170

Michael T Wallace, MD is an Emergency Medicine in Fort Benning, Georgia. Graduated from University of South Carolina School of Medicine in 2021, 5 years ago. Practices with Emergency Group of Columbus LLC, a 43-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
5
Trained at
University of South Carolina School of Medicine
Licensed in
GA
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

6600 Van Aalst Blvd Bldg 9250
Fort Benning, GA 31905-2102
Phone: (762) 408-2604
Show map & directions

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

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 12643 (GA)

Record details

NPI number1427624170
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 2, 2021
Last updated in NPPESJuly 15, 2025
Certification dateJuly 15, 2025
Mailing address6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Emergency Group Of Columbus Llc — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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