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NPI Code Detail

MEDICARE: DR. WILLIAM VAN WURM MD

MEDICARE: DR. WILLIAM VAN WURM MD
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
1208000000XPediatrics Physician20580MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205034840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM VAN WURM MD
Provider Business Mailing Address
First Line : 3631 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-5702
Country : US
Telephone Number : 228-818-0585
Fax Number : 228-818-0588
Provider Business Practice Location Address
First Line : 3631 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-5702
Country : US
Telephone Number : 228-818-0585
Fax Number : 228-818-0588
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2007
Last Update Date : 07/23/2013

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