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

Wallace Edwin Wilson, PA-C

Individual provider Physician Assistant · NPI 1841279411

Wallace Edwin Wilson, PA-C is a Physician Assistant in Cumming, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

410 Peachtree Pkwy Ste 300
Cumming, GA 30041-7407
Phone: (404) 255-1933
Fax: (404) 785-2822
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4053 (GA)

Record details

NPI number1841279411
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 12, 2006
Last updated in NPPESJune 6, 2022

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