Individual
DR. SUSANNE GERTRAUD WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 N 12TH ST, #605, PHOENIX, AZ 85006-2848
(602) 839-4567
(602) 839-2232
Mailing address
1300 N 12TH ST, #605, PHOENIX, AZ 85006-2848
(602) 839-4567
(602) 839-2232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35547
AZ
Other
Enumeration date
03/18/2007
Last updated
12/26/2012
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