Individual
BRENDA W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1650 COUNTY SERVICES PKWY, MARIETTA, GA 30008
(770) 514-2422
Mailing address
280 KENDEMERE POINTE, ROSWELL, GA 30075
(770) 490-4345
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
54700
GA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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