Provider Demographics
NPI:1811151350
Name:WILHELM, ROSS M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:M
Last Name:WILHELM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4154
Mailing Address - Country:US
Mailing Address - Phone:701-293-3060
Mailing Address - Fax:701-293-3061
Practice Address - Street 1:1605 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4154
Practice Address - Country:US
Practice Address - Phone:701-293-3060
Practice Address - Fax:701-293-3061
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist