MICHAEL T WALLACE MD
NPI 1427624170
Emergency Medicine in Fort Benning, GA
About Michael T Wallace Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL T WALLACE MD (NPI 1427624170) is an individual emergency medicine provider in Fort Benning, Georgia, licensed in Georgia (12643) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS, is affiliated with Piedmont Columbus Regional Midtown, and is a graduate of University Of South Carolina School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Michael T Wallace Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Piedmont Columbus Regional Midtown
Acute Care Hospitals · Columbus, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 31905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT MOORE, GA 31905
COLUMBUS, GA 31905
FORT MOORE, GA 31905
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Michael Wallace's NPI number?
The NPI number for Michael Wallace is 1427624170. It was assigned to this individual provider in the NPPES registry on June 2, 2021.
Where is Michael Wallace located?
Michael Wallace practices at 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905. The listed phone number is (762) 408-2604.
What is Michael Wallace's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Michael Wallace enrolled in Medicare?
Yes. Michael Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Michael Wallace affiliated with any hospitals?
According to CMS data, Michael Wallace is affiliated with Piedmont Columbus Regional Midtown.
When was this NPI record last updated?
The NPPES record for Michael Wallace was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Michael T Wallace, MD · NPI 1427624170
Emergency Medicine physician in Fort Benning, Georgia. Individual provider, active in the CMS NPPES registry since June 2, 2021.
## Identity
- **NPI:** 1427624170 (Entity type: Individual)
- **Enumerated:** June 2, 2021
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 12643 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 6600 VAN AALST BLVD BLDG 9250, Fort Benning, GA 31905-2102
- **Phone:** (762) 408-2604
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of South Carolina School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** July 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1427624170) · Data from the CMS NPPES public registry.