Organization
GERIATRIC MULTISPECIALTY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP WISOTSKY MD (MEDICAL DIRECTOR)
(301) 870-0660
Entity
Organization
Contact information
Practice address
11350 PEMBROOKE SQ STE 311, WALDORF, MD 20603-4809
(301) 870-0660
Mailing address
11350 PEMBROOKE SQ STE 311, WALDORF, MD 20603-4809
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
11/22/2021
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