Individual
RICHARD C. WISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
379 STANAFORD RD, BECKLEY, WV 25801-3141
(304) 253-3000
(304) 469-9811
Mailing address
502 MAIN ST W, OAK HILL, WV 25901-3416
(304) 465-1030
(304) 469-9811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12767
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049654000
—
WV
Enumeration date
06/13/2006
Last updated
10/22/2007
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