Provider Demographics
NPI:1093752883
Name:WIK, DANIEL M (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:WIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 23RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-8507
Mailing Address - Country:US
Mailing Address - Phone:402-563-2978
Mailing Address - Fax:402-563-2976
Practice Address - Street 1:4307 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-8507
Practice Address - Country:US
Practice Address - Phone:402-563-2978
Practice Address - Fax:402-563-2976
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47338-20208100000X
NE23401208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026101300Medicaid
NE247651OtherMIDLANDS CHOICE
NE30304OtherBCBSNE
NEP00286103OtherRR
NEI36527Medicare UPIN
NE10026101300Medicaid