Healthcare Provider Details

I. General information

NPI: 1649650276
Provider Name (Legal Business Name): STEVEN RUSSELL WILDING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVEN WILDING M.D.

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HOPE DR
HERSHEY PA
17033-2036
US

IV. Provider business mailing address

500 UNIVERSITY DR MC CA410
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-5638
  • Fax: 717-531-0983
Mailing address:
  • Phone: 717-531-5208
  • Fax: 717-531-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD-18796
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberMD489897
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: