Wilson, Michael D

Wilson, Michael D is an individual health care provider with primary practice located at 1104 Professional Blvd , Dalton GA 30720-2588. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Wilson, Michael D can be contacted via phone (706) 226-5533.

Contact Information

Primary practice address
1104 Professional Blvd Dalton GA 30720-2588
Fax: (706) 428-0033
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 041498 Georgia
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 041498 Georgia

Profile Details

NPI number 1013000801
LBN Legal business name Wilson, Michael D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Dec 19th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013000801 NPPES
Georgia MEDICAID 00869525B
Georgia Other 927802

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