Healthcare Provider Details

I. General information

NPI: 1215917299
Provider Name (Legal Business Name): CAROLINE S WILKEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 N MAIN ST STE 302
FALL RIVER MA
02720-1350
US

IV. Provider business mailing address

1822 NORTH MAIN STREET SUITE 302
FALL RIVER MA
02720
US

V. Phone/Fax

Practice location:
  • Phone: 508-235-1118
  • Fax: 508-235-1119
Mailing address:
  • Phone: 508-235-1118
  • Fax: 508-235-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number209200
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberRI7229
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: