Individual provider Active NPI

Gail Wilder, M.D.

  • Internal Medicine Physician
  • Trumbull, CT
National Provider Identifier
1093144693
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
030574 Issued in CT
Practice address
48 Monroe Tpke
Trumbull, CT 06611-1341
Phone
(203) 459-6512
NPI assigned
Nov 4, 2013
Last updated
Nov 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 124349 NY
Emergency Medicine Physician 207P00000X 030574 CT
Emergency Medicine Physician 207P00000X 25MA05494300 NJ
Family Medicine Physician 207Q00000X 25MA05494300 NJ
Internal Medicine Physician 207R00000X 124349 NY
Internal Medicine Physician 207R00000X 030574 CT Primary

Addresses

Primary practice location

48 Monroe Tpke
Trumbull, CT 06611-1341

Mailing address

10 Coolridge Rd
Milford, CT 06460-7620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05494300NJMDEmergency Medicine Physician
030574CTMDInternal Medicine Physician
124349NYMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1093144693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COOLRIDGE RD",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064607620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MONROE TPKE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111341",
            "telephone_number": "203-459-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "124349",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "030574",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA05494300",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA05494300",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "124349",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "030574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.