Individual
DR. BARRY MICHAEL WOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
916 JACKSON AVE, SHERIDAN, WY 82801-2708
(307) 675-5555
(307) 675-5599
Mailing address
916 JACKSON AVE, SHERIDAN, WY 82801-2708
(307) 675-5555
(307) 675-5599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2829A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00941001
BC BS GROUP NUMBER
WY
01
—
0193235
MEDICA INSURANCE TX
TX
01
—
100048900
WY MEDICAID GROUP NUMBER
WY
05
—
100798000
—
WY
01
—
2829A
WY MEDICAL LICENSE
WY
01
—
301605
BLUE CROSS BLUE SHIELD WY
WY
01
—
419BMW98
WY CONTROLLED SUBSTANCE
WY
01
—
53D0673733
CLIA GROUP NUMBER
—
05
—
7705130
—
SD
05
—
830245718
—
NE
Enumeration date
12/06/2005
Last updated
03/07/2023
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