EDGAR WOLLAM NPI 1316978166

NPI Information

NPI: 1316978166
Provider Name: EDGAR WOLLAM
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

Address:
1660 MULKEY RD
STE B
AUSTELL, GA
ZIP 30106
Phone: (678) 460-2700
Get Directions

Edgar Wollam is a nephrology internal medicine in Austell, GA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Edgar Wollam NPI is 1316978166. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1660 MULKEY RD
STE B
AUSTELL, GA
ZIP 30106
Phone: (678) 460-2700
Fax: (770) 739-0212

The enumeration date for this NPI number is 7/6/2006 and was last updated on 10/19/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology	19436	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	581992673003	OTHER	GEORGIA	UHC
2	920632	OTHER	GEORGIA	AETNA
3	110059639	OTHER	GEORGIA	RR MEDICARE
4	D41425	MEDICARE UPIN
5	000146187G	MEDICAID	GEORGIA
6	356860	OTHER	GEORGIA	BCBS
7	000146187F	MEDICAID	GEORGIA
8	000146187C	MEDICAID	GEORGIA
9	000146187B	MEDICAID	GEORGIA
10	0001416187H	MEDICAID	GEORGIA
11	000146187D	MEDICAID	GEORGIA
12	03169	OTHER	GEORGIA	BCBS GROUP #
13	000146187E	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »