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Individual
DR. SHENELLE-MARIE KEISHA WISE
Active
Individual
DR. SHENELLE-MARIE KEISHA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME124002
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015568700
—
FL
Enumeration date
04/18/2012
Last updated
10/28/2022
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