Individual
ANNA L WILDERMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3774 BAYLEY DR, SUITE B, LAFAYETTE, IN 47905-8651
(765) 807-8180
(765) 807-8181
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01043677A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184181
ANTHEM
IN
05
—
200028720
—
IN
Enumeration date
03/24/2006
Last updated
03/23/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us