Individual
ANDREW MARK WILHELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF PULMONARY, JACKSON, MS 39216-4500
(601) 984-5650
(601) 984-5658
Mailing address
2500 NORTH STATE STREET, DIVISION OF PULMONARY, JACKSON, MS 39216-4500
(601) 984-5601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19524
MS
207RP1001X
Pulmonary Disease Physician
Primary
19524
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03981524
—
MS
05
—
130060
—
AL
01
—
P01230907
RAILROAD MEDICARE
MS
Enumeration date
11/02/2006
Last updated
04/09/2014
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