Doctor Name: | DR. MATTHEW J. WILSON |
NPI Number: | 1003093600 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 054294 |
Business Practice Address: | 755 Mt Vernon Hwy Suite 530 Atlanta, GA - 30328 |
Business Phone Number: | 4042527970 |
Business Fax Number: | 4042500553 |
Mailing Address: | 755 Mt Vernon Hwy, Suite 530 ATLANTA |
State: | GA |
Postal Code: | 303284274 |
Phone Number: | 4042527970 |
Fax Number: | 4042500553 |
NPI Enumeration Date: | 01/25/2008 |
NPI Last Update Date: | 09/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RC0000X |
License Number: | 054294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Cardiovascular Disease |
Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |