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Individual

DR. EMILY MICHELLE WISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
20 WILLIAM ST STE G15, WELLESLEY, MA 02481-4102
(781) 591-4234
(781) 369-9737
Mailing address
20 WILLIAM ST STE G15, WELLESLEY, MA 02481-4102
(781) 591-4234
(781) 369-9737

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
254256
MA
207NS0135X
Procedural Dermatology Physician
254256
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1487882270
NPI
Enumeration date
06/30/2009
Last updated
01/08/2019
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