Individual
CARRIE LYNN WILGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 MEADOW RUN DRIVE, HASTINGS, MI 49058
(269) 818-1020
(269) 818-1266
Mailing address
300 MEADOW RUN DRIVE, HASTINGS, MI 49058
(269) 818-1020
(269) 818-1266
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301073703
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3500800182
BCBS
MI
05
—
4123869
—
MI
Enumeration date
04/11/2006
Last updated
12/13/2017
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