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Individual

MICHAEL WALTER WILDMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
N.D

Contact information

Practice address
5602 CAITO DR, INDIANAPOLIS, IN 46226-1346
(317) 942-3102
Mailing address
1138 CHATTANOOGA CIR, INDIANAPOLIS, IN 46229-9611
(812) 298-4841

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
IN
207Q00000X
Family Medicine Physician
Primary
ND20250213
IN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/04/2024
Last updated
10/19/2025
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