Provider Demographics
NPI:1427473206
Name:CRAIG A WILHELMS, DPM, PC
Entity type:Organization
Organization Name:CRAIG A WILHELMS, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILHELMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:540-772-0091
Mailing Address - Street 1:2149 ELECTRIC RD STE 5
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1975
Mailing Address - Country:US
Mailing Address - Phone:540-772-0091
Mailing Address - Fax:540-772-2983
Practice Address - Street 1:2149 ELECTRIC RD STE 5
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1975
Practice Address - Country:US
Practice Address - Phone:540-772-0091
Practice Address - Fax:540-772-2983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000686261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric