Individual
WYNHDAM GEORGE MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1968 PEACHTREE ROAD NW, ATLANTA, GA 30309-1281
(404) 351-1745
(404) 351-7121
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(954) 839-2569
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
029045
GA
207L00000X
Anesthesiology Physician
Primary
29045
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035167
—
GA
Enumeration date
07/14/2006
Last updated
05/30/2023
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