WALLACE S. WILDER MD NPI 1659431013

NPI Information

WALLACE S. WILDER MD is a primary care clinic center in Kalispell, MT. WALLACE S. WILDER MD NPI is 1659431013. The provider is registered as an organization entity type.
The provider Is Doing Business As Sunny View Pediatrics.

The provider's business location address is:

210 SUNNYVIEW LN
SUITE 103
KALISPELL, MT
ZIP 59901-135
Phone: (406) 752-8300
Fax: (406) 752-3542

The provider's authorized official is Trudy B. Waggener .
The authorized official title is Office Manager and has the following contact phone number (406) 752-8300.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 8/15/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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