Individual
MS. ANNE S WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
3569 RIDGE ROAD, CLEVELAND, OH 44102
(216) 281-0872
(216) 281-9721
Mailing address
3569 RIDGE RD, CLEVELAND, OH 44102-5443
(216) 281-8978
(216) 281-9721
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35068485W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000129992
BLUE CROSS BLUE SHIELD
OH
05
—
0153800
—
OH
01
—
341300581029
CARESOURCE
OH
01
—
353654
WELLCARE
OH
01
—
5978034
AETNA
OH
01
—
735729
BUCKEYE
OH
01
—
M68485
APEX
OH
Enumeration date
04/28/2006
Last updated
12/21/2011
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