Provider Demographics
NPI:1477138113
Name:IMW CONSULTING, PLLC
Entity Type:Organization
Organization Name:IMW CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILSHERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-468-9155
Mailing Address - Street 1:PO BOX 49
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41005-0049
Mailing Address - Country:US
Mailing Address - Phone:859-468-9155
Mailing Address - Fax:
Practice Address - Street 1:5 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-9790
Practice Address - Country:US
Practice Address - Phone:859-468-9155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty