Charles R Wilder OD PC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

4901002266 Issued in MI

Legal business name

CHARLES R WILDER OD PC

Practice address

15401 Harriet St
Romulus, MI 48174-3069

Phone

(734) 782-7200

Fax

(734) 229-9558

NPI assigned

May 4, 2011

Last updated

May 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Romeo Wilder II, ODNPI 1275562118

Title

President

Phone

(734) 782-7200

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Romeo Wilder II, O.D.,F.A.A.O.

  • Corneal and Contact Management Optometrist
  • Romulus, MI
  • NPI 1275562118
  Authorized official Same address or phone

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1982996203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15401 HARRIET ST",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481743069",
            "telephone_number": "734-782-7200",
            "fax_number": "734-229-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15401 HARRIET ST",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481743069",
            "telephone_number": "734-782-7200",
            "fax_number": "734-229-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES R WILDER OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ROMEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-782-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MI",
            "license": "4901002266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Caldwell
• Kimberly Carter
• Matthew Anthony Carter
• Steven Cavins, ATC
• Charis Doula LLC
• Chinonso Blessing Chijioke-Chukwuma
• Kathleen Ruth Chubb, BCBA
• City of Romulus (Romulus Fire Department)
• Kristin Overweg Claerhout, CTRS, CBIS
• Kristi Clark

• Case Management Agency in Romulus, MI
• Providers in Romulus, MI by specialty
• Case Management Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.