Organization
W. ROBERT WISMAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. W ROBERT WISMAN MD (PHYSICIAN)
(540) 345-8124
Entity
Organization
Contact information
Practice address
1506 FRANKLIN RD SW, ROANOKE, VA 24016-5207
(540) 345-8124
(540) 345-3423
Mailing address
1506 FRANKLIN RD SW, ROANOKE, VA 24016-5207
(540) 345-8124
(540) 345-3423
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0101014128
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006228623
—
VA
Enumeration date
06/30/2010
Last updated
07/09/2010
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