EDGAR WOLLAM – NPI #1316978166
Internal Medicine

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 is a physician located in AUSTELL, GA. NPPES has assigned the NPI number 1316978166 to EDGAR WOLLAM on July 06, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. He is also known by his other name GARY WOLLAM. The primary taxonomy selected by this provider is 207RN0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Nephrology

The NPI profile was previously updated about 15 years ago on Oct 19, 2011. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EDGAR WOLLAM below.

NPI Profile for
EDGAR WOLLAM

NPI Number
1316978166
Enumeration Date

(about 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
EDGAR WOLLAM
Other Name: GARY WOLLAM
Primary location
1660 MULKEY RD
STE B
AUSTELL, GA 30106
Phone: (678) 460-2700 Fax: (770) 739-0212
Mailing address
Same as primary location
Sole Proprietor
No
Updated
Identifiers

Identifiers for EDGAR WOLLAM

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
OTHERAETNAGA920632
OTHERBCBSGA356860
OTHERBCBS GROUP #GA03169
OTHERRR MEDICAREGA110059639
OTHERUHCGA581992673003
MEDICAIDGA000146187B
MEDICAIDGA000146187E
MEDICAIDGA0001416187H
MEDICAIDGA000146187C
MEDICAIDGA000146187F
MEDICAIDGA000146187D
MEDICAIDGA000146187G
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RN0300X
- Internal Medicine / Nephrology (Primary)
GA 19436

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.