MEDICARE: HARPER T WILDERN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4901004214	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HW004214	OTHER		BCBS OF MICHIGAN

General Provider Information

NPI Number	:	1366505398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARPER T WILDERN O.D.

Provider Business Mailing Address
First Line	:	123 LANSING ST
Second Line	:
City	:	CHARLOTTE
State	:	MI
Zip	:	48813-1696
Country	:	US
Telephone Number	:	517-543-2020
Fax Number	:	517-543-0311

Provider Business Practice Location Address
First Line	:	123 LANSING ST
Second Line	:
City	:	CHARLOTTE
State	:	MI
Zip	:	48813-1696
Country	:	US
Telephone Number	:	517-543-2020
Fax Number	:	517-543-0311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	03/13/2008

Similar Medicare Providers

1447288048 — HORIZON COUNSELING & CONSULTING SERVICES, PC
Practice Location Address:

123 LANSING ST
CHARLOTTE, MI
48813-1696

Practice Phone: 517-543-9500
Practice Fax: 517-543-9528

1538188685 — JOHN M THIEL DO
Practice Location Address:

123 LANSING ST , SUITE 2
CHARLOTTE, MI
48813-1696

Practice Phone: 517-543-7976
Practice Fax:

1407879653 — KIMBERLY R FRIAR MD
Practice Location Address:

123 LANSING ST , SUITE 3A
CHARLOTTE, MI
48813-1696

Practice Phone: 517-543-0600
Practice Fax:

1285657437 — ROBERT L LEESER MD
Practice Location Address:

123 LANSING ST , SUITE 3A
CHARLOTTE, MI
48813-1696

Practice Phone: 517-543-0600
Practice Fax:

1306952544 — FREDERICK PETER DARIN OD
Practice Location Address:

123 LANSING ST
CHARLOTTE, MI
48813-1696

Practice Phone: 517-543-2020
Practice Fax: 517-543-0311

1154481331 — EYE CARE ASSOCIATES OF CHARLOTTE PLLC
Practice Location Address:

123 LANSING ST
CHARLOTTE, MI
48813-1696

Practice Phone: 517-543-2020
Practice Fax: 517-543-0311

Directions to “ HARPER T WILDERN O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.