Wilson, Wallace Edwin
Wilson, Wallace Edwin is an individual health care provider with primary practice located at 410 Peachtree Pkwy Ste 300 , Cumming GA 30041-7407. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wilson, Wallace Edwin can be contacted via phone (404) 255-1933.Contact Information
Primary practice address
410 Peachtree Pkwy Ste 300
Cumming GA 30041-7407
Phone: (404) 255-1933
Fax: (404) 785-2822
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 4053 | Georgia |
Profile Details
| NPI number | 1841279411 |
|---|---|
| LBN Legal business name | Wilson, Wallace Edwin |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2006 |
| Last updated | Jun 6th, 2022 - about 2 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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