Individual
DR. CHARLES ROMEO WILDER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.,F.A.A.O.
Contact information
Practice address
15401 HARRIET ST, ROMULUS, MI 48174-3069
(734) 782-7200
(734) 229-9558
Mailing address
15401 HARRIET ST, ROMULUS, MI 48174-3069
(734) 782-7200
(734) 229-9558
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
4901002266
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5006929
—
MI
Enumeration date
07/02/2006
Last updated
07/09/2007
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