Individual
DR. MICHAEL C WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1305 W 18TH ST, SIOUX FALLS, SD 57105
(605) 328-4973
(605) 328-1295
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-4973
(605) 328-1295
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4888
SD
208M00000X
Hospitalist Physician
Primary
4888
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6004222
—
SD
Enumeration date
06/16/2005
Last updated
03/31/2022
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