Wilder, Brian John

Wilder, Brian John is an individual health care provider with primary practice located at 1000 Blythe Blvd , Charlotte NC 28203-5812. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Wilder, Brian John can be contacted via phone (704) 355-2372.

Contact Information

Primary practice address
1000 Blythe Blvd Charlotte NC 28203-5812
Phone: (704) 355-2372
Fax: (704) 355-6692
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 32068 North Carolina
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 32068 North Carolina

Profile Details

NPI number 1831187392
LBN Legal business name Wilder, Brian John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Oct 22nd, 2007 - about 17 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 1831187392 NPPES
South Carolina Other TL5107 MEDICAID
South Carolina MEDICAID 8987398 MEDICAID

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