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NPI Code Detail

MEDICARE: DR. DONALD L. WILHELM M.D.

MEDICARE:  DR. DONALD L. WILHELM  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician118054MO
2207RP1001XPulmonary Disease Physician118054MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00063177OTHERMOMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2409684OTHERMOHEALTHLINK
3122237OTHERMOBCBS
4DA5571OTHERMORAILROAD GROUP

General Provider Information

NPI Number : 1184604910
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD L. WILHELM M.D.
Provider Business Mailing Address
First Line : PO BOX 104240
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65110-4240
Country : US
Telephone Number : 573-556-5191
Fax Number : 573-556-5757
Provider Business Practice Location Address
First Line : 2221 BAGNELL DAM BLVD
Second Line :
City : LAKE OZARK
State : MO
Zip : 65049-8603
Country : US
Telephone Number : 573-635-5264
Fax Number : 573-556-5757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 10/18/2007

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Directions to “ DR. DONALD L. WILHELM M.D.” Practice Location

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