Individual
ASHLEY WILKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4110 51ST AVE S, FARGO, ND 58104
(701) 364-3100
Mailing address
4110 51ST AVE S, FARGO, ND 58104
(701) 364-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
65470-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001-0117101
MEDICA
—
01
—
1508201930
BCBS OF MINNESOTA
—
05
—
1508201930
—
MN
Enumeration date
04/29/2013
Last updated
02/22/2024
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