SHANE L WILDER

WEST HOLLYWOOD, CA
NPI1922667443
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: NM  MD2022-0910)
Enumeration Date2019-06-08
Last Update Date2024-10-30
Business Address
Dr. SHANE L WILDER MD
8700 BEVERLY BLVD STE 5512
WEST HOLLYWOOD, CA 90048-1804
Phone number: 310-423-2811
Mailing Address
Dr. SHANE L WILDER MD
800 BRADBURY DR SE STE 116
ALBUQUERQUE, NM 87106-4310
Phone number: 505-272-1476
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