Wilder, Stephen Mark
Wilder, Stephen Mark is an individual health care provider with primary practice located at 531 7Th Ave , Albany GA 31701-1921. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Wilder, Stephen Mark can be contacted via phone (229) 883-3535.Contact Information
Primary practice address
531 7Th Ave
Albany GA 31701-1921
Phone: (229) 883-3535
Fax: (229) 888-1079
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 000600 | Georgia |
Profile Details
| NPI number | 1750374963 |
|---|---|
| LBN Legal business name | Wilder, Stephen Mark |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2005 |
| Last updated | Dec 21st, 2009 - about 16 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 | 1750374963 | NPPES |
| Georgia | MEDICAID | 00398956A |
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