Individual
MICHAEL E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8566C N HIGHWAY 27, ROCK SPRING, GA 30739-2105
(706) 375-3520
(706) 375-9310
Mailing address
PO BOX 219, ROCK SPRING, GA 30739-0219
(706) 375-3520
(706) 375-9310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
032496
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00508802B
—
GA
01
—
146966
BCBS OF TENNESSEE
TN
01
—
293865
BCBS OF GEORGIA
GA
Enumeration date
08/25/2005
Last updated
04/14/2008
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