Wyatt Edward Sorel, PHARMD
Individual provider Active NPI Pharmacist · Webster, WI
NPI 1831912641 · NPPES record last updated Nov 1, 2024
Key facts
- NPI
- 1831912641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 22771-40 (WI)
- Practice address
- 7438 Main St W
Webster, WI 54893-8215 - Phone
- (715) 866-8644
- NPI assigned
- Nov 1, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22771-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yellow River Pharmacy Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22771-40 | WI | Yes |
Addresses
Primary practice location
7438 Main St W
Webster, WI 54893-8215
Mailing address
7438 Main St W
Webster, WI 54893-8215
Phone (715) 866-8644
Other providers in Webster, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.