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Individual

MICHAEL ERNEST WIMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1250 8TH AVE STE 600, FORT WORTH, TX 76104-4121
(817) 702-7144
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2900

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
H4803
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125518404
TX
05
125518406
TX
01
848660
BCBS
TX
01
8CX897
BCBS
TX
01
P00978119
RAILROAD MEDICARE
TX
Enumeration date
02/02/2006
Last updated
12/18/2023
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