Individual
CHARLES WIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
219 N FOREST AVE NE, MARIETTA, GA 30060-1623
(806) 335-6400
Mailing address
219 N FOREST AVE NE, MARIETTA, GA 30060-1623
(806) 335-6400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11096
GA
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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