Individual
ALFRED WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
201 CARTER ST, TEWKSBURY, MA 01876-1425
(978) 640-0004
Mailing address
201 CARTER ST, TEWKSBURY, MA 01876-1425
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
158640
MA
Other
Enumeration date
02/01/2007
Last updated
11/28/2011
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