Organization
WALLACE S. WILDER MD
Active
Other names
Sunny View Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRUDY B. WAGGENER (OFFICE MANAGER)
(406) 752-8300
Entity
Organization
Contact information
Practice address
210 SUNNYVIEW LN, SUITE 103, KALISPELL, MT 59901-3135
(406) 752-8300
(406) 752-3542
Mailing address
210 SUNNYVIEW LN, SUITE 103, KALISPELL, MT 59901-3135
(406) 752-8300
(406) 752-3542
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
3655
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0032344
—
MT
05
—
0066495
—
MT
05
—
0437529
—
MT
01
—
08110
BCBS - WALLACE WILDER MD
MT
01
—
371330
BCBS - VALERIE BEEBE
MT
01
—
92168
BCBS - MICHAEL SCHWALLER
MT
01
—
95755
BCBS - LYNN A. DYKSTRA MD
MT
Enumeration date
12/08/2006
Last updated
08/15/2011
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