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Janika Inez Wallace, DO
Family Medicine Physician in North East, Maryland
NPI 1255642930

Janika Inez Wallace is a Family Medicine Physician based in North East, MD. Janika Inez Wallace practices in North East, MD and has the professional credentials of DO. The NPI Number for Janika Inez Wallace is 1255642930 and holds a License No. (Maryland).

The current practice location address for Janika Inez Wallace is 104 E Cecil Ave, North East, MD and can be reached out via phone at 410-287-7021 and via fax at 410-287-7067.

Location: 104 E Cecil Ave, North East, MD, 21901-4016
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255642930
Provider Name
Janika Inez Wallace
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
104 E Cecil Ave, North East, MD, 21901-4016
Phone Number
410-287-7021
Fax Number
410-287-7067
Provider Enumeration Date
06/28/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
301409Y2B 01 MD MEDICARE
institution
Provider Business Practice Location Address Details
Address
104 E Cecil Ave
City
North East
State
Maryland
Zip
21901-4016
Phone Number
410-287-7021
Fax Number
410-287-7067
person
Provider Business Mailing Address Details
Address
104 E Cecil Ave
City
North East
State
Maryland
Zip
21901-4016
Phone Number
410-287-7021
Fax Number
410-287-7067
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
25MB09205500 (New Jersey)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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