Wild, Robert Marshall

Wild, Robert Marshall is an individual health care provider with primary practice located at 905 University Dr , State College PA 16801-6626. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Wild, Robert Marshall can be contacted via phone (814) 238-8418.

Contact Information

Primary practice address
905 University Dr State College PA 16801-6626
Phone: (814) 238-8418
Fax: (814) 234-2888
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD019167E Pennsylvania

Profile Details

NPI number 1528047024
LBN Legal business name Wild, Robert Marshall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated Aug 3rd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528047024 NPPES
Pennsylvania MEDICAID 0006452750001

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