Individual
MICHAEL WYSOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 CHESTNUT ST, PHILADELPHIA, PA 19107-3612
(215) 955-8988
Mailing address
1112 N HANCOCK ST APT H0814, PHILADELPHIA, PA 19123-1889
(516) 521-8811
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD485195
PA
Other
Enumeration date
03/24/2018
Last updated
08/27/2024
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