Organization
JEFFREY WISHIK MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY M WISHIK MD (OWNER)
(401) 274-5150
Entity
Organization
Contact information
Practice address
1 RANDALL SQ, SUITE 409, PROVIDENCE, RI 02904-2709
(401) 274-5150
Mailing address
1 RANDALL SQ, SUITE 409, PROVIDENCE, RI 02904-2709
(401) 274-5150
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD07160
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200984
BLUECHIP
RI
01
—
26335
RI BCBS
RI
Enumeration date
04/28/2008
Last updated
03/30/2021
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