Wallace Edwin Wilson, PA-C

NPI #1841279411 in Cumming, Georgia

Provider Information

NPI Number: 1841279411
Entity Type: Individual
Name: Wallace Edwin Wilson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jan 12, 2006
Last Updated: Jun 6, 2022

Practice Location

Address: 410 PEACHTREE PKWY STE 300
City: Cumming
State: Georgia
ZIP Code: 30041-7407
Phone: (404) 255-1933

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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