Individual
KYLE WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1945 STATE ROUTE 33, NEPTUNE, NJ 07753-4859
(732) 775-5500
Mailing address
1945 STATE ROUTE 33, NEPTUNE, NJ 07753-4859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB11811600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2020
Last updated
05/14/2024
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