MEDICARE: WILLIAM CHRISTIAN WILHELM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD010269E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00170328	OTHER	PA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	120701	OTHER	PA	BLUE SHIELD
3	212712	OTHER	PA	UPMC
5	00051996001	OTHER	NY	UNIVERA
6	522600	OTHER	PA	AETNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	66434	OTHER	PA	UNISON
10	P000955	OTHER	PA	GATEWAY

General Provider Information

NPI Number	:	1578562369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM CHRISTIAN WILHELM MD

Provider Business Mailing Address
First Line	:	717 STATE ST
Second Line	:	SUITE 16
City	:	ERIE
State	:	PA
Zip	:	16501-1341
Country	:	US
Telephone Number	:	814-480-7100
Fax Number	:	814-480-7604

Provider Business Practice Location Address
First Line	:	300 STATE ST
Second Line	:	SUITE 301
City	:	ERIE
State	:	PA
Zip	:	16507-1427
Country	:	US
Telephone Number	:	814-877-7907
Fax Number	:	814-877-6791

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	05/15/2008

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Directions to “ WILLIAM CHRISTIAN WILHELM MD” Practice Location

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