Individual
STACI K WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1800 HOWELL MILL RD NW, SUITE 450, ATLANTA, GA 30318-2538
(404) 355-4393
(404) 419-9852
Mailing address
1800 HOWELL MILL NWRD 450, ATLANTA, GA 30318-2508
(404) 355-4393
(404) 609-7649
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
004739
GA
Other
Enumeration date
04/26/2007
Last updated
04/11/2017
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