| NPI | 1538926811 | 
|---|---|
| Professional Name | WALTER MICHAEL WILDMAN | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN nd20250213) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-04 | 
| Last Update Date | 2025-10-19 |