DR. KIM WILDER-DYER (NPI# 1629068945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629068945 |
| Entity Type | Individual |
| Full Name | DR. KIM WILDER-DYER |
| Credential | MD |
| Practice Address |
700 Church St Ne Marietta GA 30060-7220 |
| Practice Telephone | 7704201600 |
| Practice Fax Number | 7704201612 |
| Mailing Telephone | 7704201600 |
| Mailing Fax Number | 7704201612 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-02-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 026957 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1810 White Cir Ste 120, Marietta, GA 300665836 | 7704201600 | 7704201612 |
| Street Address |
700 CHURCH ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-7220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912325655 | Rheumatology Associates of Marietta | Clinic/Center | 700 Church St Ne, Marietta, GA 30060-7220 | 2014-03-31 |
| 1992082739 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2011-11-08 |
| 1114210127 | Wellstar Medical Group, LLC | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2011-05-24 |
| 1538465109 | Wellstar Medical Group, LLC | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2011-01-31 |
| 1639302250 | Allyson Joy Underwood | Nurse Practitioner | 700 Church St Ne, Marietta, GA 30060-7220 | 2009-08-30 |
| 1710114517 | Xena Antoinette Whittier | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2009-06-18 |
| 1326239823 | A. Henry Randall Jr. | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2007-08-08 |
| 1720287188 | Wellstar Rheumatology Associates of Marietta, LLC | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2007-07-16 |
| 1821044207 | Wellstar Marietta Primary Care, LLC | Internal Medicine | 700 Church St Ne, Marietta, GA 30060-7220 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399475 | Janice Carol Gould | Internal Medicine | 140 Vann St Ne Ste 350, Marietta, GA 30060-8975 | 2020-09-01 |
| 1952914368 | Hardy Renew Wellness,llc | Internal Medicine | 838 Cannon Run Sw, Marietta, GA 30064-4600 | 2020-08-25 |
| 1881202752 | Zandoc Group Corp | Internal Medicine | 2759 Delk Rd Se Ste 1603, Marietta, GA 30067-8887 | 2020-07-16 |
| 1548892458 | Atlanta Osteoarthritis Center LLC | Internal Medicine | 2550 Windy Hill Rd Se Ste 308, Marietta, GA 30067-8655 | 2020-02-08 |
| 1952949893 | Dr Amy L Varner LLC | Internal Medicine | 1000 Johnson Ferry Rd Bldg E Ste 200, Marietta, GA 30068 | 2019-12-11 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1295392140 | Camden-clark Physician Corporation | Internal Medicine | 26 Acme St, Marietta, OH 45750-3306 | 2019-05-28 |
| 1821572447 | Cies Global - Georgia LLC | Internal Medicine | 780 Canton Rd Ne Ste 205, Marietta, GA 30060-7242 | 2018-09-19 |
| 1164943510 | David Hout Mason Jr. | Internal Medicine | 3615 Paper Mill Rd Se, Marietta, GA 30067-4938 | 2017-07-06 |
| 1942678628 | Claudia Michelle Brauer Ornelas | Internal Medicine | 401 Matthew St Dept Of, Marietta, OH 45750-1635 | 2015-09-11 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.