Provider Demographics
NPI:1487831459
Name:GEORGE A. WILHELM
Entity Type:Organization
Organization Name:GEORGE A. WILHELM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-438-4000
Mailing Address - Street 1:1263 NATIONAL PIKE
Mailing Address - Street 2:P.O. BOX 476
Mailing Address - City:HOPWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15445
Mailing Address - Country:US
Mailing Address - Phone:724-438-4000
Mailing Address - Fax:724-438-7010
Practice Address - Street 1:1263 NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:HOPWOOD
Practice Address - State:PA
Practice Address - Zip Code:15445
Practice Address - Country:US
Practice Address - Phone:724-438-4000
Practice Address - Fax:724-438-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-001828-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001504358OtherBLUE CROSS/BLUE SHIELD
PA0732138Medicaid
PA767814Medicare PIN
PA001504358OtherBLUE CROSS/BLUE SHIELD