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Individual
MICHAEL PRESTON WYNN
Active
Individual
MICHAEL PRESTON WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPH
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
040819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040819
LICENSE NUMBER
GA
Enumeration date
09/11/2006
Last updated
07/23/2008
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