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Contact Information

CHARLES R WILDER II, O.D.,F.A.A.O.
15401 HARRIET ST
ROMULUS, MI48174-3069
 Phone: 734-782-7200
 Fax: 734-229-9558
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for CHARLES R WILDER II · (Male)

NPI Number 1275562118
Status Active
Credentials O.D.,F.A.A.O.
Entity Individual
Enumeration date 07/02/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # 4901002266
  • MI Medicaid 5006929
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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