IndividualActive
Mark Wallace, D.O.
NPI 1952591828 · Otolaryngology/Facial Plastic Surgery Physician · Rockport, ME
Provider details
- NPI number
- 1952591828
- Entity type
- Individual
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- License
- 5101015234 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
15 Anchor Dr Ste 102
Rockport, ME 04856-3847
Phone: (207) 301-3660
Fax: (207) 301-5160
Approximate (ZIP-level) locationGet directions
Mailing address
15 Anchor Dr Ste 102
Rockport, ME 04856-3847
Additional practice locations (2)
- 116 Northport Ave Ste 118Belfast, ME 04915-6096Phone: (207) 505-4367Fax: (207) 338-4486
- 333 Magazine StSuite 101Sault Sainte Marie, MI 49783-1867Phone: (906) 259-0244Fax: (906) 259-0247
Registry dates
- Enumerated
- 2007-07-27
- Last updated
- 2026-01-29
- Certified
- 2026-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.