National Provider Identifier Database

EDGAR WOLLAM
Nephrology

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.

Contact Information

EDGAR WOLLAM
1660 MULKEY RD
STE B
AUSTELL, GA  30106
Phone: 678-460-2700
Fax: 770-739-0212
Website:
Specialty Taxonomy Code
* Nephrology 207RN0300X

* Indicates primary specialty

NPI Profile & details for EDGAR WOLLAM

NPI Number 1316978166
Credentials
Entity Individual
Enumeration date 07/06/2006
Last updated 10/19/2011 - About 15 years ago
Sole proprietor1 No
Identifiers
  • GA License #: 19436
  • GA Medicaid: 0001416187H
  • GA Medicaid: 000146187B
  • GA Medicaid: 000146187C
  • GA Medicaid: 000146187D
  • GA Medicaid: 000146187E
  • GA Medicaid: 000146187F
  • GA Medicaid: 000146187G
  • GA Other: 920632 AETNA
  • GA Other: 356860 BCBS
  • GA Other: 03169 BCBS GROUP #
  • GA Other: 110059639 RR MEDICARE
  • GA Other: 581992673003 UHC
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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