Individual
MR. MARTIN NUROCK WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6801 MAYFIELD ROAD, SUITE 444, MAYFIELD HGTS, OH 44124-2209
(440) 449-8890
(440) 449-7580
Mailing address
6801 MAYFIELD ROAD, SUITE 444, MAYFIELD HGTS, OH 44124-2209
(440) 449-8890
(440) 449-7580
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35059554W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000142196
ANTHEM
OH
05
—
0881783
—
OH
01
—
2382068
AETNA HMO
OH
01
—
3419207200
BWC
OH
01
—
4306387
AETNA NON HMO
OH
Enumeration date
08/29/2006
Last updated
07/08/2007
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