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

Mr. Lawrence Wallace, MD, PT

Individual provider Orthopaedic Surgery Physician · NPI 1679567192

Mr. Lawrence Wallace, MD, PT is a Physical Therapist in Private Practice in North Myrtle Beach, South Carolina. Qualified in 1997, 29 years ago. Practices with Elite Hand and Upper Extremity Therapy, a 6-clinician group and accepts Medicare assignment. Licensed in North Carolina, Pennsylvania, South Carolina and Virginia.

Years since qualifying
29
Licensed in
NC, PA, SC, VA
In the registry since
2005
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1021 2nd Ave N Ste 6
North Myrtle Beach, SC 29582-3200
Phone: (843) 286-5168
Fax: (844) 318-8980
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11194 (SC)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence MD439714 (PA)
Physical Therapist Taxonomy 225100000X · Licence P2177 (NC)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 0101234728 (VA)

Record details

NPI number1679567192
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , PT
Sole proprietorNo
NPI enumeratedSeptember 12, 2005
Last updated in NPPESJanuary 26, 2026
Certification dateJanuary 26, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Elite Hand And Upper Extremity Therapy — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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