Individual
DR. MICHAEL ROBERT WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 1ST AVE NW, NEW PRAGUE, MN 56071-1403
(952) 758-3090
(952) 758-8053
Mailing address
310 1ST AVE NW, NEW PRAGUE, MN 56071-1403
(952) 758-3090
(952) 758-8053
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20837
MN
207Q00000X
Family Medicine Physician
Primary
20837
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420872200
—
MN
Enumeration date
07/18/2006
Last updated
03/23/2011
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