Most Relevant Information
Provider Data
| NPI Number: | 1003570953 |
| Provider Name: | MATTHEW BOG WILDER |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 182595 |
Most Important Dates
| Enumeration Date: | 10/27/2021 |
| Last Updated: | 03/17/2022 |
Provider Practice Location
3601 THE VANDERBILT CLINIC
NASHVILLE
TN
372325030
Practice Location Phone/Fax
| Phone: | 6153223000 |
| Fax: |
Provider Mailing Location
3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE
TN
372152691
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |