Individual
NATHAN WADE ANISKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
777 HEMLOCK ST # 104, MACON, GA 31201-2102
(478) 633-7550
(478) 633-3235
Mailing address
777 HEMLOCK ST # 104, MACON, GA 31201-2102
(478) 633-7550
(478) 633-3235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
90702
GA
208M00000X
Hospitalist Physician
Primary
90644
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/26/2020
Last updated
09/15/2025
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