Individual
DR. MATTHEW EVERT WIISANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2205 MCCALLIE AVE, CHATTANOOGA, TN 37404-3230
(423) 508-6733
(423) 508-6744
Mailing address
2205 MCCALLIE AVE, CHATTANOOGA, TN 37404-3230
(423) 508-6733
(423) 508-6744
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12800
ND
207R00000X
Internal Medicine Physician
42001
KY
207R00000X
Internal Medicine Physician
54571
TN
207RC0000X
Cardiovascular Disease Physician
12800
ND
207RC0000X
Cardiovascular Disease Physician
54571
TN
207RI0011X
Interventional Cardiology Physician
12800
ND
207RI0011X
Interventional Cardiology Physician
Primary
54571
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176925100
—
MN
Enumeration date
08/04/2006
Last updated
01/31/2022
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