MEDICARE: TERRENCE D WILKIN 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
1	2085R0202X	Diagnostic Radiology Physician	01048976A	IN
2	2085R0204X	Vascular & Interventional Radiology Physician	01048976A	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1982656963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRENCE D WILKIN MD

Provider Business Mailing Address
First Line	:	121 S SAINT LOUIS BLVD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-2924
Country	:	US
Telephone Number	:	574-233-3123
Fax Number	:	574-233-3125

Provider Business Practice Location Address
First Line	:	611 E DOUGLAS RD STE 200
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-1465
Country	:	US
Telephone Number	:	574-272-5347
Fax Number	:	574-272-8617

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	01/13/2025

Similar Medicare Providers

1659321545 — DR. SANDRA C ROLAND M.D.
Practice Location Address:

611 E DOUGLAS RD STE 200
MISHAWAKA, IN
46545-1465

Practice Phone: 574-335-6850
Practice Fax: 574-335-0849

1700090602 — DR. ERIC DAVID KNAPP D.O.
Practice Location Address:

611 E DOUGLAS RD STE 207
MISHAWAKA, IN
46545-1465

Practice Phone: 574-335-6850
Practice Fax: 574-335-0849

1811105810 — DR. PRAVIN PRATAP M.D.
Practice Location Address:

611 E DOUGLAS RD STE 208
MISHAWAKA, IN
46545-1465

Practice Phone: 574-335-6700
Practice Fax: 574-335-0726

1548471311 — DR. HARSHA SANTHESHIVARA NAGARAJARAO M.D.
Practice Location Address:

611 E DOUGLAS RD STE 208
MISHAWAKA, IN
46545-1465

Practice Phone: 574-335-6700
Practice Fax:

1659543643 — WILLIAM HANLEY NP
Practice Location Address:

611 E DOUGLAS RD STE 200
MISHAWAKA, IN
46545-1465

Practice Phone: 574-335-6060
Practice Fax: 574-335-0611

1508025867 — ZIAD YOUSSEF FAYAD MD
Practice Location Address:

611 E DOUGLAS RD STE 200
MISHAWAKA, IN
46545-1465

Practice Phone: 574-272-5347
Practice Fax: 574-272-8617

Directions to “ TERRENCE D WILKIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.