Individual
KATHRYN B WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
77 HOSPITAL AVE, SUITE 302, NORTH ADAMS, MA 01247-2550
(413) 663-8365
(413) 662-2363
Mailing address
77 HOSPITAL AVE, SUITE 302, NORTH ADAMS, MA 01247-2550
(413) 663-8365
(413) 662-2363
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
159650
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006997
—
VT
05
—
3195210
—
MA
Enumeration date
12/21/2005
Last updated
06/22/2011
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