Individual
DR. RALF G WILDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 SCHOOL ST, CLARKS SUMMIT, PA 18411-1508
(570) 586-3587
(570) 586-0337
Mailing address
100 NIKELLE LN, SOUTH ABINGTON TOWNSHIP, PA 18411-2866
(570) 586-2624
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD060289L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101359647
—
PA
Enumeration date
03/21/2006
Last updated
10/28/2008
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