Individual
DR. JAMES EDWARD WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11085 LITTLE PATUXENT PKWY STE 103, COLUMBIA, MD 21044-2914
(410) 730-1988
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
47272
AZ
208600000X
Surgery Physician
Primary
D92452
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
895706
—
AZ
01
—
Z175473
MEDICARE
AZ
Enumeration date
11/25/2007
Last updated
06/17/2022
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