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General NPI Number Information
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NPI Number | 1093876716
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Entity Type | Organization
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Legal Business Name | MICHAEL M WYDILA MD PA
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1403 SILVERSIDE RD STE 4B
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City | WILMINGTON
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State | DE
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Zip | 19810-4434
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Country | US
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Telephone | 302-798-8070
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Fax | 302-798-5902
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Provider Business Mailing Address
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Address Line | 1403 SILVERSIDE RD STE 4B
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City | WILMINGTON
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State | DE
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Zip | 19810-4434
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Country | US
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Telephone | 302-798-8070
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Fax | 302-798-5902
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Authorized Official
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Title or Position | PRESIDENT AND OWNER
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Name | DR. MICHAEL MARTIN WYDILA
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Credential | MD
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Telephone | 302-798-8070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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