Individual provider · Type 1 NPI

Michael T. Wallace, MD

Emergency Medicine Physician · Fort Benning, GA

NPI number 1427624170 Active

Practice location

6600 Van Aalst Blvd Bldg 9250
Fort Benning, GA 31905-2102

Call (762) 408-2604 Map

Specialties and licenses

TaxonomyCodeLicense
Emergency Medicine Physician Primary 207P00000X12643 (GA)

Emergency Medicine Physician: An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in respo…

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About NPI 1427624170

Michael T. Wallace, MD's National Provider Identifier is 1427624170, issued on Jun 2, 2021. The primary taxonomy on file is Emergency Medicine Physician (207P00000X), and the practice location is in Fort Benning, GA. The record was last updated on Jul 15, 2025.