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Individual

DR. PAMELA SUE BUCKLEW-WILDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
30 W MCCREIGHT AVE, SUITE 106, SPRINGFIELD, OH 45504-1842
(937) 523-9820
(937) 523-9829
Mailing address
30 W MCCREIGHT AVE, SUITE 106, SPRINGFIELD, OH 45504-1842
(937) 523-9820
(937) 523-9829

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35061787B
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0829278
OH
Enumeration date
06/24/2005
Last updated
08/29/2012
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