Wilde, Kim L

Wilde, Kim L is an individual health care provider with primary practice located at 1001 E Superior St Ste L401 , Duluth MN 55802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wilde, Kim L can be contacted via phone (218) 249-7960.

Contact Information

Primary practice address
1001 E Superior St Ste L401 Duluth MN 55802
Phone: (218) 249-7960
Fax: (218) 249-7997
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2534 South Dakota
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 65959 Minnesota

Profile Details

NPI number 1891744140
LBN Legal business name Wilde, Kim L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2006
Last updated Dec 4th, 2020 - about 4 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 1891744140 NPPES
South Dakota MEDICAID 6000743

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