Individual
WILMOT R GISSENDANNER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2871
Mailing address
PO BOX 23321, NEW YORK, NY 10087-3321
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
SC
Other
Enumeration date
12/06/2025
Last updated
12/06/2025
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