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Individual

DR. DONALD L. WILHELM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2221 BAGNELL DAM BLVD, LAKE OZARK, MO 65049-8603
(573) 635-5264
(573) 556-5757
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 556-5191
(573) 556-5757

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
118054
MO
207RP1001X
Pulmonary Disease Physician
118054
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
122237
BCBS
MO
01
409684
HEALTHLINK
MO
01
DA5571
RAILROAD GROUP
MO
01
P00063177
MEDICARE RAILROAD
MO
Enumeration date
01/18/2006
Last updated
10/18/2007
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