Individual
MELYSSA DIANE WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
609 W GERMANTOWN PIKE STE 220, EAST NORRITON, PA 19403-4261
(484) 622-7940
Mailing address
609 W GERMANTOWN PIKE STE 220, EAST NORRITON, PA 19403-4261
(484) 622-7940
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD484622
PA
390200000X
Student in an Organized Health Care Education/Training Program
TL.0008180
CO
Other
Enumeration date
04/15/2020
Last updated
04/09/2025
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