Individual
WAYNE G WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7074 HIGHLAND RD STE A, WATERFORD, MI 48327-1500
(248) 698-2000
(248) 698-2655
Mailing address
7074 HIGHLAND RD STE A, WATERFORD, MI 48327-1500
(248) 698-2000
(248) 698-2655
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002777
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900F367410
BCBSM
MI
Enumeration date
02/15/2006
Last updated
02/25/2009
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