Individual
DR. BENJAMIN MICHAEL WISOTSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2121 MEDICAL PARK DR, STE 3, SILVER SPRING, MD 20902-4054
(301) 681-3003
Mailing address
1301 M ST NW, APT 707, WASHINGTON, DC 20005-4201
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036161592
IL
2085R0202X
Diagnostic Radiology Physician
236247
NY
2085R0202X
Diagnostic Radiology Physician
Primary
D69487
MD
2085R0202X
Diagnostic Radiology Physician
TPME5505
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418075500
—
MD
01
—
TPME5505
FLORIDA DEPARTMENT OF HEALTH, DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
04/27/2009
Last updated
03/09/2026
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