Individual
DR. JEFFREY W WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7985 S MACKINAW TRL, CADILLAC, MI 49601-8111
(231) 876-7200
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 876-7200
(231) 547-8088
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301067907
MI
207V00000X
Obstetrics & Gynecology Physician
65787
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160055213
RR MEDICARE
MI
01
—
160B41011
BCBS MI
MI
01
—
383445481
TAX ID
MI
05
—
4197610
—
MI
Enumeration date
03/10/2006
Last updated
03/05/2026
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