Individual
DAVID A. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
755 WALTHER RD, LAWRENCEVILLE, GA 30046-8725
(770) 962-0399
(770) 995-0533
Mailing address
755 WALTHER RD, LAWRENCEVILLE, GA 30045-8725
(770) 962-0399
(770) 995-0533
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
39267
GA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
39267
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00622993A
—
GA
Enumeration date
09/23/2005
Last updated
06/29/2021
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