Individual
MICHAEL JAMES WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 778-3900
Mailing address
1700 WELIKA DR, DECATUR, GA 30032-4330
(619) 733-5584
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
12900
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/04/2024
Last updated
12/22/2025
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