Individual
DR. AMANDA LOUISE WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DR, SAN DIEGO, CA 92134-5000
(813) 679-0028
Mailing address
MCAGCC BOX 7888260, 29 PALMS, CA 92278
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101267521
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/07/2018
Last updated
05/09/2022
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