Healthcare Provider Details

I. General information

NPI: 1871790394
Provider Name (Legal Business Name): WESLEY CHAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1465
US

IV. Provider business mailing address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1465
US

V. Phone/Fax

Practice location:
  • Phone: 404-352-2020
  • Fax: 404-350-7381
Mailing address:
  • Phone: 404-350-3074
  • Fax: 404-350-7381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD445764
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number077574
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN11514
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: