Provider Demographics
NPI:1326163585
Name:DR. WILHELMSEN & ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DR. WILHELMSEN & ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RINGELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-823-3885
Mailing Address - Street 1:7401 OSLER DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7673
Mailing Address - Country:US
Mailing Address - Phone:410-823-3885
Mailing Address - Fax:410-823-6888
Practice Address - Street 1:7401 OSLER DR
Practice Address - Street 2:SUITE 208
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-7673
Practice Address - Country:US
Practice Address - Phone:410-823-3885
Practice Address - Fax:410-823-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032637208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52665001OtherBLUE SHIELD PROVIDER #
MD52665001OtherBLUE SHIELD PROVIDER #
MDD74406Medicare UPIN
MD231LMedicare ID - Type Unspecified