Individual
MR. ETHAN JACOB WAJSWOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD (5/18/2020)
Contact information
Practice address
470 NORTHSIDE CHEROKEE BLVD STE 201, CANTON, GA 30115-8029
(770) 720-7246
(770) 720-4620
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
99892
GA
Other
Enumeration date
02/24/2020
Last updated
06/26/2025
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