Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Ethan Jacob Wajswol, MD5/18/2020

Individual provider Urology Physician · NPI 1366076945

Mr. Ethan Jacob Wajswol, MD5/18/2020 is an Urology in Canton, Georgia. Graduated from Rutgers New Jersey Medical School in 2020, 6 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
6
Trained at
Rutgers New Jersey Medical School
Licensed in
GA
In the registry since
2020

Practice location Address checks out

470 Northside Cherokee Blvd Ste 201
Canton, GA 30115-8029
Phone: (770) 720-7246
Fax: (770) 720-4620
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 99892 (GA)

Record details

NPI number1366076945
Entity typeIndividual (Type 1)
GenderMale
Credentials MD5/18/2020
Sole proprietorNo
NPI enumeratedFebruary 24, 2020
Last updated in NPPESJune 26, 2025
Certification dateJune 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolRUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated 2020 (6 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Canton