Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. TREVOR GLADE WILDE, D.O.
ActiveDR. TREVOR GLADE WILDE, D.O. is a Family Medicine healthcare provider located in SAINT ANTHONY, Idaho. NPI 1538422019 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · SAINT ANTHONY, ID
Registration Details
- NPI Number
- 1538422019
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 20, 2012 (14.137211307008 yrs)
- Last Updated
- Aug 16, 2024
- License
-
O-0776 (ID)
Practice Information
- Address
-
335 E MAIN ST STE 1SAINT ANTHONY, ID, 834451546Browse ID providers · Browse ZIP 83445
- Phone
- 2083564900
- Fax
- 2086244116
- Primary Specialty
-
Family Medicine
207Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.