Individual
DR. KENNETH H WILDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4315 EASTON AVE, SUITE 2, BETHLEHEM, PA 18020-1498
(610) 868-8850
(610) 868-8845
Mailing address
4315 EASTON AVE, SUITE 2, BETHLEHEM, PA 18020-1498
(610) 868-8850
(610) 868-8845
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD012151E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0783413
—
PA
Enumeration date
06/27/2006
Last updated
08/01/2007
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