Individual
SUSAN R WILHELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
202 S PARK ST, MERITER ATRIUM, MADISON, WI 53715-1507
(608) 417-5970
(608) 417-5966
Mailing address
202 S PARK ST, MERITER ATRIUM, MADISON, WI 53715-1507
(608) 417-5970
(608) 417-5966
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
769-023
WI
363AM0700X
Medical Physician Assistant
Primary
769-023
WI
363AS0400X
Surgical Physician Assistant
769-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3962
DEAN HEALTH INSURANCE
WI
05
—
42949700
—
WI
01
—
970010936
RAILRAOD MEDICARE
WI
Enumeration date
05/08/2006
Last updated
05/04/2021
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