Individual
JEFFREY L WILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-6300
Mailing address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301052876
MI
207RP1001X
Pulmonary Disease Physician
4301052876
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C97618
BCBS
MI
05
—
1033226097
—
MI
01
—
2904118571
BCBS OF MICHIGAN
MI
05
—
3161767
—
MI
Enumeration date
08/24/2006
Last updated
04/02/2010
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