Provider Demographics
NPI:1598796047
Name:WILHELM, GEORGE A
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:WILHELM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-001828-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103274OtherUPMC
PW001504358OtherBLUE CROSS/BLUE SHIELD
PA0732138Medicaid
PA767814Medicare PIN
PW001504358OtherBLUE CROSS/BLUE SHIELD