Individual
DR. STEVEN GEORGE WILDERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1005 W GREEN ST, RM 301, HASTINGS, MI 49058-1729
(269) 945-2419
(269) 945-0357
Mailing address
1005 W GREEN ST, STE 201, HASTINGS, MI 49058-1726
(269) 945-2419
(269) 945-0357
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SW039857
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1340544
—
MI
01
—
CN0332
PALMETTO GBA RAILROAD
MI
Enumeration date
06/10/2005
Last updated
12/16/2016
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