Robert S. Wildin MD

NPI 1073586897 - Medical Genetics - 207SG0201X

NPI Details
NPI 1073586897
Gender Male
Enumeration Date 02/10/2006
Last Updated 01/29/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
190 E BANNOCK ST
ST. LUKE'S CHILDREN'S SPECIALTY CTR (CSC SUITE 200)
BOISE ID, 83712-6241, US
Phone (208) 381-7339
Fax (208) 381-6186
Business Location
6140 SW 41ST AVE
PORTLAND OR, 97221-3344, US
Phone (503) 768-9547
Fax (503) 768-9547
Toxanomy
Taxonomy Code 207SG0201X
License State Oregon
License Number MD20420
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According to our database, Dr. Robert S. Wildin MD NPI is 1073586897, taxonomy code is 207SG0201X and license number is MD20420, license state is located at Oregon. Robert S. Wildin MD physically located at 190 E Bannock St, Boise ID, 83712-6241. NPI Number Robert S. Wildin MD has the Individual type.

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1073586897 NPI number is provided on an as is basis without warranty of any kind. 1073586897 is maintained by the National Plan & Provider Enumeration System. The contents of Robert S. Wildin MD are for informational purposes only.