Wilcox, Michael Robert

Wilcox, Michael Robert is an sole proprietor health care provider with primary practice located at 310 1St Ave Nw , New Prague MN 56071-1403. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Wilcox, Michael Robert can be contacted via phone (952) 758-3090.

Contact Information

Primary practice address
310 1St Ave Nw New Prague MN 56071-1403
Fax: (952) 758-8053
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 20837 Minnesota
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20837 Minnesota

Profile Details

NPI number 1801814504
LBN Legal business name Wilcox, Michael Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated Mar 23rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801814504 NPPES
Minnesota MEDICAID 420872200

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