Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 20909 | MS |
N | 207RP1001X | Pulmonary Disease | 20909 | MS |
NPI | 1154529709 |
---|---|
Provider Name | Dr. Chelle P Wilhelm |
First Address | Jackson, MS 39216-4829 |
Second Address | Jackson, MS 39216-4829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 25/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03309314 | (05) | MS |