Healthcare Provider Details

I. General information

NPI: 1174739148
Provider Name (Legal Business Name): MICHAEL JOSHUA WILHELM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 BRIARGATE PKWY STE 120
COLORADO SPRINGS CO
80920-7699
US

IV. Provider business mailing address

2060 BRIARGATE PKWY STE 120
COLORADO SPRINGS CO
80920-7699
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-3800
  • Fax: 719-301-3855
Mailing address:
  • Phone: 719-301-3800
  • Fax: 719-301-3855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number24018
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: