Individual
DR. STEPHANIE KRESCH WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3100 MARTIN LUTHER KING JR PKWY, SPRINGFIELD, OR 97477-7514
(541) 868-9700
(541) 485-7392
Mailing address
PO BOX 70368, SPRINGFIELD, OR 97475-0120
(541) 485-2777
(541) 246-2353
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
6360465-1205
UT
207V00000X
Obstetrics & Gynecology Physician
Primary
MD176904
OR
207V00000X
Obstetrics & Gynecology Physician
TP119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500714052
—
OR
Enumeration date
10/01/2007
Last updated
03/08/2022
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