Provider Demographics
NPI:1700049210
Name:WILKIE, ANN COTCAMP (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:COTCAMP
Last Name:WILKIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:KATHERINE
Other - Last Name:COTCAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5301 MCAULEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-5368
Mailing Address - Country:US
Mailing Address - Phone:734-712-3325
Mailing Address - Fax:734-712-5525
Practice Address - Street 1:5301 MCAULEY DRIVE
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-5368
Practice Address - Country:US
Practice Address - Phone:734-712-3325
Practice Address - Fax:734-712-5525
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092001208000000X, 207R00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program