Wilde, Wayne G
Wilde, Wayne G is an sole proprietor health care provider with primary practice located at 7074 Highland Rd Ste A , Waterford MI 48327-1500. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wilde, Wayne G can be contacted via phone (248) 698-2000.Contact Information
Primary practice address
7074 Highland Rd Ste A
Waterford MI 48327-1500
Phone: (248) 698-2000
Fax: (248) 698-2655
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901002777 | Michigan |
Profile Details
| NPI number | 1104890342 |
|---|---|
| LBN Legal business name | Wilde, Wayne G |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Feb 25th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104890342 | NPPES |
| Michigan | Other | 900F367410 | BCBSM |
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