Wilder, Lawrence L.

Wilder, Lawrence L. is an individual health care provider with primary practice located at 1213 15Th Ave W , Williston ND 58801-3800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilder, Lawrence L. can be contacted via phone (701) 572-7651.

Contact Information

Primary practice address
1213 15Th Ave W Williston ND 58801-3800
Fax: (701) 774-7482
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3807 North Dakota

Profile Details

NPI number 1851319925
LBN Legal business name Wilder, Lawrence L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Jul 8th, 2007 - about 19 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 1851319925 NPPES
North Dakota Other 14062 BLUE CROSS OF ND
North Dakota MEDICAID 12910 BLUE CROSS OF ND

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