Alan P K Wild MD

NPI 1871582692 - Otolaryngology - 207Y00000X

NPI Details
NPI 1871582692
Gender Male
Enumeration Date 10/14/2005
Last Updated 11/20/2009
Entity Type Individual
Active Over 11 years ago
Practice Location
3660 VISTA AVE
STE. 312
SAINT LOUIS MO, 63110, US
Phone (314) 977-5110
Fax (314) 977-5119
Business Location
3635 VISTA AVE
P.O. BOX 15250
SAINT LOUIS MO, 63110-2539, US
Phone (314) 577-8884
Fax (314) 268-5111
Toxanomy
Taxonomy Code 207Y00000X
License State Missouri
License Number R9D17
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According to our database, Alan P K Wild MD NPI is 1871582692, taxonomy code is 207Y00000X and license number is R9D17, license state is located at Missouri. Alan P K Wild MD physically located at 3660 Vista Ave, Saint Louis MO, 63110. NPI Number Alan P K Wild MD has the Individual type.

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1871582692 NPI number is provided on an as is basis without warranty of any kind. 1871582692 is maintained by the National Plan & Provider Enumeration System. The contents of Alan P K Wild MD are for informational purposes only.