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Individual

DR. STEPHEN MARK WILDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
531 7TH AVE, ALBANY, GA 31701-1921
(229) 883-3535
(229) 888-1079
Mailing address
531 7TH AVE, ALBANY, GA 31701-1921
(229) 883-3535
(229) 888-1079

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000600
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00398956A
GA
Enumeration date
08/24/2005
Last updated
12/21/2009
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