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Individual
CAROL JEAN WILDER
Active
Individual
CAROL JEAN WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00048866
WA
207Q00000X
Family Medicine Physician
Primary
MD185352
OR
207QS0010X
Sports Medicine (Family Medicine) Physician
00048866
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
10509
HI
Other
Enumeration date
10/05/2006
Last updated
03/25/2021
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