Individual
BRIAN ANDREW WISSEL
Active
Individual
BRIAN ANDREW WISSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01082691A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
309624
LA
390200000X
Student in an Organized Health Care Education/Training Program
11017276A
IN
Other
Enumeration date
06/05/2013
Last updated
11/13/2019
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