RAEGAN DEWILDE
Physician Assistant - Medical
Active
Individual
NPI: 1780226084
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | No | - |
| Physician Assistant - Medical | 363AM0700X | Yes | - |
Frequently Asked Questions
NPI 1780226084 is the National Provider Identifier for RAEGAN DEWILDE, a Physician Assistant - Medical provider located in Fairview, OK. This NPI was enumerated on October 8, 2019.
RAEGAN DEWILDE practices at 523 E STATE RD, Fairview, OK 73737.
Quick Facts
- NPI
- 1780226084
- Type
- Individual
- Enumerated
- Oct 8, 2019
- Last Updated
- Jun 8, 2022
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