Healthcare Provider Details

I. General information

NPI: 1982776241
Provider Name (Legal Business Name): WENDY S GILES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 VANN ST NE STE 310
MARIETTA GA
30060-8963
US

IV. Provider business mailing address

140 VANN ST NE STE 310
MARIETTA GA
30060-8963
US

V. Phone/Fax

Practice location:
  • Phone: 678-401-2403
  • Fax: 678-401-2354
Mailing address:
  • Phone: 678-401-2403
  • Fax: 678-401-2354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number33091
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: