Organization
VAN WURM MD,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM VAN WURM M.D. (OWNER)
(228) 818-0585
Entity
Organization
Contact information
Practice address
3631 BIENVILLE BLVD, SUITE A, OCEAN SPRINGS, MS 39564-5702
(228) 818-0585
(228) 818-0588
Mailing address
3631 BIENVILLE BLVD, SUITE A, OCEAN SPRINGS, MS 39564-5702
(228) 818-0585
(228) 818-0588
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
20580
MS
261QP2300X
Primary Care Clinic/Center
20580
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03673557
—
MS
Enumeration date
12/10/2015
Last updated
01/19/2017
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