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Organization
DR. SHOUKRI M. WISA MEDICAL CARE PLLC
Active
Organization
DR. SHOUKRI M. WISA MEDICAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHOUKRI MINA WISA M.D. (OWNER)
(585) 343-6363
Entity
Organization
Contact information
Practice address
164 WASHINGTON AVE, BATAVIA, NY 14020-2113
(585) 343-6363
(585) 343-1986
Mailing address
164 WASHINGTON AVE, BATAVIA, NY 14020-2113
(585) 343-6363
(585) 343-1986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
Primary
—
NULL
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
04/03/2014
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