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General NPI Number Information
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NPI Number | 1619760238
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Entity Type | Individual
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Provider Name | CHARLES CHRISTOPHER WILHELM ACNPC-AG, BSN, RN
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Gender | Male
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 20000 HARVARD AVE
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City | WARRENSVILLE HEIGHTS
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State | OH
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Zip | 44122-6805
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Country | US
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Telephone | 216-318-9434
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Fax |
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Provider Business Mailing Address
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Address Line | 293 E 150TH ST
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City | CLEVELAND
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State | OH
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Zip | 44110-1210
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Country | US
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Telephone | 216-318-9434
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | APRN.CNP.0038789
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License Number State | OH
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