Individual
RICHARD B WISE
Active
Individual
RICHARD B WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MA72455
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2398350000
AMERIHEALTH
—
01
—
3840133
AETNA HMO
—
01
—
60000622
HORIZON MERCY
NJ
05
—
8640408
—
NJ
Enumeration date
06/08/2005
Last updated
01/03/2008
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