Individual
KYLE WILEBSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
(701) 530-8984
Mailing address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
(701) 530-8984
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15712
ND
208D00000X
General Practice Physician
RL 13722
ND
390200000X
Student in an Organized Health Care Education/Training Program
11018737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477922
—
ND
Enumeration date
06/23/2015
Last updated
08/03/2023
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