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Individual

DR. WILLIAM MANN WILSHIRE IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
931 HIGHLAND BLVD, SUITE 3310, BOZEMAN, MT 59715
(406) 587-8478
(406) 582-0730
Mailing address
931 HIGHLAND BLVD, SUITE 3310, BOZEMAN, MT 59715
(406) 587-8478
(406) 582-0730

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
103
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000002571
BCBS
MT
01
000082949
MEDICARE GROUP
MT
05
0390337
MT
01
480027217
RAILROAD MEDICARE
Enumeration date
10/05/2006
Last updated
05/22/2014
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