Individual
DAVID J WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
68 SE 6TH ST APT 2804, MIAMI, FL 33131
(404) 895-1536
Mailing address
68 SE 6TH ST APT 2804, MIAMI, FL 33131-3493
(404) 895-1536
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125960
FL
207Q00000X
Family Medicine Physician
42979
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000729594J
—
GA
Enumeration date
10/24/2005
Last updated
07/18/2018
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