Healthcare Provider Details

I. General information

NPI: 1194645192
Provider Name (Legal Business Name): KARL WILHELM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5290 IVY HILL DR
CARMEL IN
46033-8990
US

IV. Provider business mailing address

5290 IVY HILL DR
CARMEL IN
46033-8990
US

V. Phone/Fax

Practice location:
  • Phone: 317-366-2430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06007107A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: