Healthcare Provider Details

I. General information

NPI: 1437728896
Provider Name (Legal Business Name): PETER WILCOX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 06/21/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 CHERRY ST
TOLEDO OH
43608-2603
US

IV. Provider business mailing address

2213 CHERRY ST
TOLEDO OH
43608-2603
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-3232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301511615
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.156130
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: