Individual
MICHAEL D WILMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7500 MERCY RD, ALEGENT BERGAN MERCY DEPT OF RADIOLOGY, OMAHA, NE 68124-2319
(402) 398-5890
Mailing address
PO BOX 4460, OMAHA, NE 68104
(866) 491-5807
(913) 491-0411
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13524
NE
2085R0202X
Diagnostic Radiology Physician
21241
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01572
BCBS
NE
01
—
1042
MIDLANDS
—
01
—
1600004
UHC SHARE ALLIANCE
—
01
—
1600518
UHC SHARE ALLIANCE
—
01
—
19055
BCBS
IA
05
—
2973347
—
IA
05
—
5973347
—
IA
05
—
6973347
—
IA
05
—
7973347
—
IA
05
—
8973347
—
IA
01
—
BW6851326
IA CONTROLLED SUBSTANCE
—
Enumeration date
06/20/2006
Last updated
03/07/2023
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