# PHILIP WISOTSKY M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942279039
- **Authorized official:** DEBBIE KIPPLE (OFFICE MANAGER)
- **Authorized official phone:** (301) 870-0660

## Contact information

- **Practice address:** 12070 OLD LINE CENTRE \#207, WALDORF, MD 20602-2567
- **Practice address phone:** (301) 870-0660
- **Practice address fax:** (301) 932-8310
- **Mailing address:** 12070 OLD LINE CENTRE \#207, WALDORF, MD 20602-2567
- **Mailing address phone:** (301) 870-0660
- **Mailing address fax:** (301) 932-8310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D18548 | MD | Yes |

## Other

- **Enumeration date:** 03/14/2006
- **Last updated:** 06/21/2018