Stephen William Wilde M.D.

NPI 1023002763 - Internal Medicine - 207RG0100X

NPI Details
NPI 1023002763
Gender Male
Enumeration Date 09/08/2005
Last Updated 04/10/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
700 SUNSET DR
SUITE 501
ATHENS GA, 30606-2293, US
Phone (706) 208-0065
Fax (706) 459-8693
Business Location
700 SUNSET DR
SUITE 501
ATHENS GA, 30606-2293, US
Phone (706) 208-0065
Fax (706) 549-8693
Toxanomy
Taxonomy Code 207RG0100X
License State Georgia
License Number 033231
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According to our database, Dr. Stephen William Wilde M.D. NPI is 1023002763, taxonomy code is 207RG0100X and license number is 033231, license state is located at Georgia. Stephen William Wilde M.D. physically located at 700 Sunset Dr, Athens GA, 30606-2293. NPI Number Stephen William Wilde M.D. has the Individual type.

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1023002763 NPI number is provided on an as is basis without warranty of any kind. 1023002763 is maintained by the National Plan & Provider Enumeration System. The contents of Stephen William Wilde M.D. are for informational purposes only.