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Individual

DR. MICHELLE WILKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7493
Mailing address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7493

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA07462400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0043079
NJ
01
2446864
UNITED HEALTH CARE
NJ
01
60009297
HORIZON NJ HEALTH
NJ
01
7332601
AETNA US HEALTHCARE
NJ
Enumeration date
12/18/2006
Last updated
07/08/2007
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