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NPI Code Detail

MEDICARE: MICHAEL J WURM MD

MEDICARE: MICHAEL J WURM 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
1207Q00000XFamily Medicine PhysicianR5C38MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679578884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J WURM MD
Provider Business Mailing Address
First Line : 114 E SOUTH HILLS DR
Second Line :
City : MARYVILLE
State : MO
Zip : 64468-2659
Country : US
Telephone Number : 660-562-2525
Fax Number : 660-562-4303
Provider Business Practice Location Address
First Line : 2016 S MAIN ST
Second Line :
City : MARYVILLE
State : MO
Zip : 64468-2659
Country : US
Telephone Number : 660-562-2525
Fax Number : 660-562-4050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 11/09/2012

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