Individual
GERALD W WILMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 UNIVERSITY DR, MARYVILLE, MO 64468-6015
(660) 562-1348
(660) 562-1857
Mailing address
800 UNIVERSITY DRIVE, MARYVILLE, MO 64468
(660) 562-1348
(660) 562-1585
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R1J97
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203109921
—
MO
Enumeration date
11/29/2006
Last updated
06/13/2017
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