Provider Demographics
NPI:1881667988
Name:MAYS, WALLACE DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:WALLACE
Middle Name:DAVID
Last Name:MAYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:151 MAYO ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3735
Mailing Address - Country:US
Mailing Address - Phone:229-928-2900
Mailing Address - Fax:229-928-2682
Practice Address - Street 1:151 MAYO ST
Practice Address - Street 2:SUITE B
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3735
Practice Address - Country:US
Practice Address - Phone:229-928-2900
Practice Address - Fax:229-928-2682
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2008-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA207V00000X207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00189472AMedicaid
GAGRP623OtherMEDICARE GRP #
GAD40576Medicare UPIN