Individual
WILLIAM J WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 E SOUTHPORT RD, STE 200, INDIANAPOLIS, IN 46227-8590
(317) 781-4588
(317) 782-4885
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01038528A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200020140A
—
IN
Enumeration date
11/16/2005
Last updated
03/17/2021
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