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Individual

NEVILLE R. WICHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
00021845
AL
2085R0202X
Diagnostic Radiology Physician
Primary
13966
MS
2085R0202X
Diagnostic Radiology Physician
ME88885
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
25025853
MS
01
512G700003
MS MEDICARE - GROUP
MS
01
CD5130
GROUP #
01
DG7781
RAILROAD - GROUP
01
P00462360
RAILROAD MEDICARE
01
P00621714
RAILROAD MEDICARE
Enumeration date
02/06/2006
Last updated
11/06/2014
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