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General NPI Number Information
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NPI Number | 1427473206
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Entity Type | Organization
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Legal Business Name | CRAIG A WILHELMS, DPM, PC
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Dates
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Enumeration Date | 03/03/2014
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 2149 ELECTRIC RD STE 5
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City | ROANOKE
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State | VA
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Zip | 24018-1975
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Country | US
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Telephone | 540-772-0091
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Fax | 540-772-2983
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Provider Business Mailing Address
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Address Line | 2149 ELECTRIC RD STE 5
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City | ROANOKE
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State | VA
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Zip | 24018-1975
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Country | US
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Telephone | 540-772-0091
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Fax | 540-772-2983
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG A WILHELMS
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Credential | DPM
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Telephone | 540-772-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 0103000686
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License Number State | VA
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