Wildermuth, Anna L
Wildermuth, Anna L is an individual health care provider with primary practice located at 3774 Bayley Dr Suite B, Lafayette IN 47905-8651. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wildermuth, Anna L can be contacted via phone (765) 807-8180.Contact Information
Primary practice address
3774 Bayley Dr Suite B
Lafayette IN 47905-8651
Phone: (765) 807-8180
Fax: (765) 807-8181
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 01043677A | Indiana |
Profile Details
| NPI number | 1255391066 |
|---|---|
| LBN Legal business name | Wildermuth, Anna L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Mar 23rd, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255391066 | NPPES |
| Indiana | MEDICAID | 200028720 | |
| Indiana | Other | 000000184181 |
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