Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gregory Stephen Wallace, MD

Individual provider Family Medicine Physician · NPI 1265902092

Gregory Stephen Wallace, MD is a Family Medicine Physician in Atlanta, Georgia. Practices as a sole proprietor. Licensed in California and Georgia.

Licensed in
CA, GA
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1042 Mason Woods Dr NE
Atlanta, GA 30329-3802
Phone: (678) 974-7424
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 051099 (GA)
Family Medicine Physician Taxonomy 207Q00000X · Licence G81645 (CA)

Record details

NPI number1265902092
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedDecember 5, 2018
Last updated in NPPESDecember 5, 2018

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