# CAROL WILDER MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417195488
- **Authorized official:** DR. CAROL WILDER MD (PRESIDENT)
- **Authorized official phone:** (808) 345-6976

## Contact information

- **Practice address:** 45 MOHOULI ST, HILO, HI 96720-4145
- **Practice address phone:** (808) 845-0728
- **Mailing address:** PO BOX 11148, HILO, HI 96721-6148
- **Mailing address phone:** (808) 345-6976

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 10509 | HI | Yes |

## Other

- **Enumeration date:** 01/29/2009
- **Last updated:** 02/02/2009