Provider Demographics
NPI:1851375547
Name:WOHL, BARRY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MICHAEL
Last Name:WOHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:916 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2708
Mailing Address - Country:US
Mailing Address - Phone:307-675-5555
Mailing Address - Fax:307-675-5599
Practice Address - Street 1:916 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2708
Practice Address - Country:US
Practice Address - Phone:307-675-5555
Practice Address - Fax:307-675-5599
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY2829A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY00941001OtherBC BS GROUP NUMBER
TX0193235OtherMEDICA INSURANCE TX
SD7705130Medicaid
NE830245718Medicaid
53D0673733OtherCLIA GROUP NUMBER
WY100048900OtherWY MEDICAID GROUP NUMBER
WY2829AOtherWY MEDICAL LICENSE
WY419BMW98OtherWY CONTROLLED SUBSTANCE
WY100798000Medicaid
WY301605OtherBLUE CROSS BLUE SHIELD WY
WY301605OtherBLUE CROSS BLUE SHIELD WY
WY419BMW98OtherWY CONTROLLED SUBSTANCE
TX0193235OtherMEDICA INSURANCE TX
WY301605OtherBLUE CROSS BLUE SHIELD WY