Williams, Wanda J

Williams, Wanda J is an individual health care provider with primary practice located at 1045 Southcrest Dr Ste 110, Stockbridge GA 30281. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Williams, Wanda J can be contacted via phone (770) 507-2212.

Contact Information

Primary practice address
1045 Southcrest Dr Ste 110 Stockbridge GA 30281
Fax: (770) 507-2213
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 040109 Georgia

Profile Details

NPI number 1932158383
LBN Legal business name Williams, Wanda J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jan 30th, 2013 - about 13 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 1932158383 NPPES
Georgia Other 52576619 BCBS
Georgia MEDICAID 000661889Q BCBS

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