MEDICARE: PAUL E WILMETH D.V.M.

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
1	174M00000X	Veterinarian	CS00016995	NM

General Provider Information

NPI Number	:	1770840035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL E WILMETH D.V.M.

Provider Business Mailing Address
First Line	:	PO BOX 3049
Second Line	:	2435 HWY 180 E
City	:	SILVER CITY
State	:	NM
Zip	:	88062-3049
Country	:	US
Telephone Number	:	575-388-2581
Fax Number	:	575-388-5060

Provider Business Practice Location Address
First Line	:	2435 HIGHWAY 180 E
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7792
Country	:	US
Telephone Number	:	575-388-2581
Fax Number	:	575-388-5060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2012
Last Update Date	:	04/11/2012

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