Provider Demographics
NPI:1659326346
Name:ANDREWS, WILSON P (MD)
Entity Type:Individual
Prefix:
First Name:WILSON
Middle Name:P
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WILSON
Other - Middle Name:PITTMAN
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2155 POST OAK TRITT RD
Mailing Address - Street 2:STE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062
Mailing Address - Country:US
Mailing Address - Phone:770-973-4700
Mailing Address - Fax:770-565-0326
Practice Address - Street 1:2155 POST OAK TRITT RD
Practice Address - Street 2:STE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:770-973-4700
Practice Address - Fax:770-565-0326
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028709208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics