Provider Demographics
NPI:1518398270
Name:DAVID E. WILMOT, MD
Entity Type:Organization
Organization Name:DAVID E. WILMOT, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILMOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-408-3056
Mailing Address - Street 1:7393 WINDRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-8801
Mailing Address - Country:US
Mailing Address - Phone:317-408-3056
Mailing Address - Fax:
Practice Address - Street 1:7393 WINDRIDGE WAY
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-8801
Practice Address - Country:US
Practice Address - Phone:317-408-3056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038693A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty