Individual
MICHAEL D WILMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
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
Update your record
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