Individual
DR. RYAN EDWARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 HOSPITAL BLVD STE 320, ROSWELL, GA 30076-0001
(770) 410-4520
(770) 410-4525
Mailing address
4500 HOSPITAL BLVD STE 320, ROSWELL, GA 30076-0001
(770) 410-4520
(770) 410-4525
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME112912
FL
207R00000X
Internal Medicine Physician
TRN13691
FL
207RI0011X
Interventional Cardiology Physician
45950
KY
207RI0011X
Interventional Cardiology Physician
51981
SC
207RI0011X
Interventional Cardiology Physician
Primary
93581
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124179A
—
GA
05
—
005571300
—
FL
01
—
14K5A
BCBSFL
FL
05
—
519816
—
SC
Enumeration date
05/19/2009
Last updated
02/20/2023
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