Individual
NATHANIEL ROBERT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1365 CLIFTON RD NE BLDG C, ATLANTA, GA 30322-1013
(618) 975-0382
Mailing address
1365 CLIFTON RD NE BLDG C, ATLANTA, GA 30322-1013
(618) 975-0382
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
S8403
TX
207RH0003X
Hematology & Oncology Physician
Primary
103955
GA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/01/2019
Last updated
05/12/2025
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