Individual
ANNE MARIE WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2020 CAPITOL ST NE, SALEM, OR 97301-0644
(503) 399-2424
(503) 375-7432
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
(503) 375-7432
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD14110
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134407
—
OR
Enumeration date
10/02/2006
Last updated
12/19/2016
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