| Matthew Alan Wild, CRNA | |
|
400 S Clark St, Butte, MT 59701-2328 | |
| (406) 723-2500 | |
| Not Available |
| Full Name | Matthew Alan Wild |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 400 S Clark St, Butte, Montana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902882558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | CRNA0370 (Arizona) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | CRA-3451 (Colorado) | Primary |
| Entity Name | Us Anesthesia Partners Of Colorado Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922365782 PECOS PAC ID: 6002072055 Enrollment ID: O20120725000032 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Alan Wild, CRNA 10 Town Plz # 67, Durango, CO 81301-5104 Ph: (970) 412-9808 | Matthew Alan Wild, CRNA 400 S Clark St, Butte, MT 59701-2328 Ph: (406) 723-2500 |
Lee Baidinger Fenwick, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 S Clark St, Butte, MT 59701 Phone: 406-723-2500 | |
James D. Chambers, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 S Clark St, Butte, MT 59701 Phone: 406-723-2500 | |
Thomas B. Stelmak, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 400 S Clark St, Butte, MT 59701 Phone: 406-723-2500 | |
Jessica Ann Simmons, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 S Clark St, Butte, MT 59701 Phone: 406-723-2500 | |
John H. Craft, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 400 S Clark St, Butte, MT 59701 Phone: 406-723-2500 | |
Cara N. Peterson, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 400 S Clark St, Butte, MT 59701 Phone: 406-723-2500 |