Individual
CHARMAINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 QUARTZ DR STE 103, VILLA RICA, GA 30180-3255
(770) 812-3530
Mailing address
4485 FULTON INDUSTRIAL BLVD SW, ATLANTA, GA 30336-1761
(706) 449-2884
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
068021
GA
2084P0800X
Psychiatry Physician
2026012136
MO
2084P0800X
Psychiatry Physician
4301101215
MI
2084P0800X
Psychiatry Physician
ME144680
FL
Other
Enumeration date
08/06/2008
Last updated
04/13/2026
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