DR. BERNADETTE MARIA MANDES WILDEMORE (NPI# 1487863858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487863858 |
| Entity Type | Individual |
| Full Name | DR. BERNADETTE MARIA MANDES WILDEMORE |
| Credential | MD |
| Practice Address |
134 Ansley Dr Ste 500 Dahlonega GA 30533-1641 |
| Mailing Address |
4405 Roseman Trl Cumming GA 30040-9367 |
| Practice Telephone | 6788532419 |
| Mailing Telephone | 2156097472 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2014-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD50706 | TN | Other Service Providers |
| N | 174400000X | Specialist | 242668 | MA | Other Service Providers |
| N | 174400000X | Specialist | MD36443 | SC | Other Service Providers |
| N | 174400000X | Specialist | MD430740 | PA | Other Service Providers |
| N | 174400000X | Specialist | MD.33137 | AL | Other Service Providers |
| N | 174400000X | Specialist | 70607 | GA | Other Service Providers |
| N | 174400000X | Specialist | 2013-02274 | NC | Other Service Providers |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
MD430740 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
134 ANSLEY DR STE 500 |
| City | DAHLONEGA |
| State | GA |
| Zip Code | 30533-1641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093320244 | Brittany Jamison | Speech-Language Pathologist | 180 Horizon Drive, Dahlonega, GA 30533 | 2020-09-14 |
| 1386109718 | Leanna Scoggin | Specialist/Technologist | 50 Hawksnest Dr, Apt. 300, Dahlonega, GA 30533 | 2019-02-11 |
| 1558753665 | Chelsey Park Health & Rehabilitation LLC | Skilled Nursing Facility | 200 Mountain Park Drive, Dahlonega, GA 30533 | 2015-02-26 |
| 1609286574 | Lanier Dental Group, Inc | Clinic/Center | 5458 S Chestatee, Dahlonega, GA 30533 | 2014-05-01 |
| 1265787444 | Lumpkin County Emergency Medical Services | Ambulance | 57a Pine Tree Way, Dahlonega, GA 30533 | 2012-07-13 |
| 1750651170 | Karen Lee Barrett | Nurse Practitioner | 82 College Ln, Dahlonega, GA 30533 | 2012-01-02 |
| 1427333095 | Dahlonega Pediatric and Adolescent Medicine | Pediatrics | 1055 North Grove St., Dahlonega, GA 30533 | 2011-10-14 |
| 1851690259 | Anselm Kwaku Addo | Pharmacist | 566 East Main St, Dahlonega, GA 30533 | 2011-03-24 |
| 1497064810 | The Maher Rehabilitation Institute LLC | Physical Therapist | 155 Sunset Drive, Dahlonega, GA 30533 | 2010-10-04 |
| 1639498926 | Georgia Mountains Community Services | Day Training, Developmentally Disabled Services | 1220 Pecks Mill Road, Dahlonega, GA 30533 | 2010-05-26 |
| Find all providers in zip 30533 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957148 | Thomas E Cotter | Pathology | 1120 15th St # Bf-103b, Augusta, GA 30912-0004 | 2020-06-17 |
| 1386269835 | Pramila Pallikkappara Moideen | Pathology | Augusta University Medical Center Room Bf-103-b, Augusta, GA 30912-0001 | 2020-06-10 |
| 1558921973 | Anna Nielsen Walker | Pathology | Mercer University School of Medicine Dept of Pathology, Macon, GA 31207-0001 | 2019-06-18 |
| 1437678950 | Thomas William Stewart Jr. | Pathology | 3138 Marthasville Court, Gainesville, GA 30506 | 2017-09-15 |
| 1700225760 | Robert John Nelms Jr. | Pathology | 107 Fairway Dr, Moultrie, GA 31768-6823 | 2013-06-22 |
| 1750725099 | Charles Jacob Stoudenmire | Pathology | 507 W 3rd Ave Ste 7, Albany, GA 31701 | 2013-04-17 |
| 1902143589 | Lindsey Oreita Lowder | Pathology | 1968 Peachtree Rd Nw Bldg 774th, Atlanta, GA 30309-1281 | 2013-01-15 |
| 1184918476 | Stephen Alan Dayan | Pathology | 830 Johns Landing Way, Lawrenceville, GA 30045-6369 | 2011-06-03 |
| 1760793673 | Andrew Erling Johnsen | Pathology | 3248 Avalon Pkwy, Conyers, GA 30013-6320 | 2010-06-24 |
| 1497066518 | Charles Omar Wilson Jr. | Pathology | 175 Samaritan Way, Jasper, GA 30143 | 2010-06-23 |
| Find all providers with the same taxonomy | ||||
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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.