Provider Demographics
NPI:1790895415
Name:WILKIN, NATHANIEL K (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:K
Last Name:WILKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 16297
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-2297
Mailing Address - Country:US
Mailing Address - Phone:661-947-9000
Mailing Address - Fax:310-446-4408
Practice Address - Street 1:300 W SPRING ST UNIT 1204
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-7656
Practice Address - Country:US
Practice Address - Phone:614-452-9800
Practice Address - Fax:614-448-2720
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2016-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200501355207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH88905OtherUPIN
NC5901558Medicaid
OHH88905OtherUPIN
NC2044424Medicare ID - Type Unspecified