Individual
DR. GREG A WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 VENTURE PL, GROVEPORT, OH 43125-9206
(614) 836-2273
(614) 836-9320
Mailing address
4100 VENTURE PL, GROVEPORT, OH 43125-9206
(614) 836-2273
(614) 836-9320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-5595
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0720161
—
OH
Enumeration date
01/31/2006
Last updated
04/06/2010
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