Brendan Wallace, MD Valid NPI
Individual provider · Urology Physician · Bangor, ME
- NPI
- 1164159257
- Type
- Individual (Type 1)
- Primary specialty
- Urology Physician (Urology)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 208800000X
- License number
- MD25666 (ME)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2022-08-08
- Last updated
- 2022-08-08
Practice location
55 Broadway
Bangor, ME 04401-5201
(207) 947-0469