Individual
GUSTAV C WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
161 IOTLA STREET, FRANKLIN, NC 28734
(828) 369-4244
(828) 349-6767
Mailing address
161 IOTLA STREET, FRANKLIN, NC 28734
(828) 421-0460
(828) 349-6767
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32974
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51937
MEDCOST
NC
01
—
87403
BCBSNC
NC
05
—
8987403
—
NC
Enumeration date
05/19/2006
Last updated
04/25/2018
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