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

Scott Andrew Wallace, MD

Individual provider Aerospace Medicine Physician · NPI 1275809899

Scott Andrew Wallace, MD is a Preventive Medicine in Annapolis, Maryland. Qualified in 2012, 14 years ago. Practices as a sole proprietor. Licensed in Maryland.

Years since qualifying
14
Licensed in
MD
In the registry since
2012
Specialties on file
2
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

695 Kinkaid Rd
Annapolis, MD 21402-1006
Phone: (410) 320-0010
Show map & directions

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

Specialties & licences

Preventive Medicine/Occupational Environmental Medicine Physician (primary) Taxonomy 2083P0500X · Licence D76451 (MD)
Aerospace Medicine Physician Taxonomy 2083A0100X · Licence D0076451 (MD)

Record details

NPI number1275809899
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 28, 2012
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026
Mailing address8901 Wisconsin Ave Bldg 85t, Bethesda, MD 20889-0004

Medicare enrollment

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

Medicare specialtyPREVENTIVE MEDICINE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Not indicated