Individual
JOHN WISENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MARTHA JEFFERSON DR, CHARLOTTESVILLE, VA 22911-4668
(434) 654-7000
Mailing address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 924-0000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101281282
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
04/01/2021
Last updated
04/05/2024
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