Individual
HARPER T WILDERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
123 LANSING ST, CHARLOTTE, MI 48813-1696
(517) 543-2020
(517) 543-0311
Mailing address
123 LANSING ST, CHARLOTTE, MI 48813-1696
(517) 543-2020
(517) 543-0311
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004214
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HW004214
BCBS OF MICHIGAN
—
Enumeration date
12/19/2006
Last updated
03/13/2008
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