Individual
THOMAS WIXTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9927 MICKELBERRY RD NW, SUITE 121, SILVERDALE, WA 98383-9195
(360) 613-1335
Mailing address
9927 MICKELBERRY RD NW, SUITE 121, SILVERDALE, WA 98383-9195
(360) 613-1335
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD60109911
WA
208600000X
Surgery Physician
MT179602
PA
Other
Enumeration date
01/18/2007
Last updated
03/01/2017
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