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Individual
DR. ROBIN I WISCH
Active
Individual
DR. ROBIN I WISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0061968
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004
BCBS
—
01
—
2129389
MAMSI
—
01
—
3657175
AETNA HMO
—
01
—
406069500
AMERIGROUP
—
05
—
406069500
—
MD
01
—
64298901
BCBS
—
01
—
796253
AETNA PPO
—
Enumeration date
08/16/2005
Last updated
05/30/2013
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