Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | AP10616 | AZ |
N | 207R00000X | Internist | AP10616 | AZ |
N | 111NI0900X | Internist | AP10616 | AZ |
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP10616 | AZ |
NPI | 1033614367 |
---|---|
Provider Name | Mr. William (bill) Mitchell Wilhelm |
First Address | Tucson, AZ 85743-5025 |
Second Address | Tucson, AZ 85723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2018 |
Last Update Date | 31/05/2018 |