Individual
DENNIS CRAIG WILDERMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1850 N CENTRAL AVE, STE 1600, PHOENIX, AZ 85004
(602) 744-4765
(602) 744-4799
Mailing address
1850 N CENTRAL AVE, STE 1600, PHOENIX, AZ 85004-4527
(602) 262-8900
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
3938
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
828410
—
AZ
01
—
P00368008
MEDICARE RAILROAD
—
Enumeration date
01/27/2006
Last updated
06/25/2018
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