1598796047 NPI number — GEORGE A WILHELM

Table of content: GEORGE A WILHELM (NPI 1598796047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598796047 NPI number — GEORGE A WILHELM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILHELM
Provider First Name:
GEORGE
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598796047
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1263 NATIONAL PIKE
Provider Second Line Business Mailing Address:
P.O. BOX 476
Provider Business Mailing Address City Name:
HOPWOOD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-438-4000
Provider Business Mailing Address Fax Number:
724-438-7010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1263 NATIONAL PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOPWOOD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-438-4000
Provider Business Practice Location Address Fax Number:
724-438-7010
Provider Enumeration Date:
07/05/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC-001828-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103274 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001504358 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".
  • Identifier: 0732138 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".