Individual
CARLY W WILBUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3461 WARRENSVILLE CENTER RD, SHAKER HTS, OH 44122-5260
(216) 383-0100
(216) 383-6481
Mailing address
PO BOX 74606, CLEVELAND, OH 44194-0689
(216) 991-4180
(216) 991-7329
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35083155
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2439427
—
OH
Enumeration date
09/26/2006
Last updated
08/29/2012
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