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Individual

ADAM MICHAEL WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
80 SEYMOUR ST, HARTFORD HOSPITAL EMERGENCY MEDICINE, HARTFORD, CT 06102-5037
(860) 972-0000
Mailing address
80 SEYMOUR ST, HARTFORD HOSPITAL EMERGENCY MEDICINE, HARTFORD, CT 06102-5037
(860) 972-0000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
054132
CT
390200000X
Student in an Organized Health Care Education/Training Program
125059806
IL

Other

Enumeration date
07/01/2011
Last updated
07/31/2015
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