Individual
DR. MICHAEL DANIEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNAP, CRNA
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0211
Mailing address
112 WARREN RD, AUGUSTA, GA 30907-3755
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN239744
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN239744
GA
Other
Enumeration date
04/28/2021
Last updated
06/09/2021
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