Brendan Wallace, MD

NPI #1164159257 in Bangor, Maine

Provider Information

NPI Number: 1164159257
Entity Type: Individual
Name: Brendan Wallace, MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Urology
Credential: MD
Enumeration Date: Aug 8, 2022
Last Updated: Aug 8, 2022

Practice Location

Address: 55 BROADWAY
City: Bangor
State: Maine
ZIP Code: 04401-5201
Phone: (207) 947-0469

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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