Individual
SAMUEL MICHAEL WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
340 FALCON RIDGE PKWY STE 403, MESQUITE, NV 89027-8851
(435) 668-8867
Mailing address
340 FALCON RIDGE PKWY STE 403, MESQUITE, NV 89027-8851
(435) 668-8867
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23475
NV
183500000X
Pharmacist
9765691-1701
UT
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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