Dr Jeffrey W Wilder, MD | |
14651 W Upright St, Charlevoix, MI 49720-1266 | |
(231) 547-4477 | |
(231) 547-4753 |
Full Name | Dr Jeffrey W Wilder |
---|---|
Gender | Male |
Speciality | Obstetrics & Gynecology |
Location | 14651 W Upright St, Charlevoix, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164490611 | NPI | - | NPPES |
160B41011 | Other | MI | BCBS MI |
383445481 | Other | MI | TAX ID |
160055213 | Other | MI | RR MEDICARE |
4197610 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 65787 (Minnesota) | Secondary |
207V00000X | Obstetrics & Gynecology | 4301067907 (Michigan) | Primary |
Entity Name | Dickinson County Healthcare System |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891751186 PECOS PAC ID: 6800784943 Enrollment ID: O20040310000583 |
Entity Name | Munson Healthcare Cadillac |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336539063 PECOS PAC ID: 6305161514 Enrollment ID: O20150401000808 |
Mailing Address | Practice Location Address |
---|---|
Dr Jeffrey W Wilder, MD 14700 Lake Shore Drive, Charlevoix, MI 49720-1930 Ph: (231) 547-4024 | Dr Jeffrey W Wilder, MD 14651 W Upright St, Charlevoix, MI 49720-1266 Ph: (231) 547-4477 |
Dr. Mary A Ivey, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 14700 Park Ave, Charlevoix, MI 49720 Phone: 231-547-4477 Fax: 231-547-4753 | |
Trisha J Tomkins, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 14651 W Upright St, Charlevoix, MI 49720 Phone: 231-547-4477 | |
Caitlyn Monks, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 14651 W Upright St, Charlevoix, MI 49720 Phone: 231-547-4477 Fax: 231-392-7334 | |
William Edwin Mosher Iii, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 14700 Park, Charlevoix, MI 49720 Phone: 231-547-4477 Fax: 231-547-4753 | |
James Jeakle, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 14700 Park Ave, Charlevoix, MI 49720 Phone: 231-547-4477 Fax: 231-547-4753 |