Individual
NICHOLAS KURT WISCHMEIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3420 S MERCY RD STE 200, GILBERT, AZ 85297
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
56351
AZ
207X00000X
Orthopaedic Surgery Physician
94-07858
KS
207X00000X
Orthopaedic Surgery Physician
ME131765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020494500
—
FL
01
—
7179580
CIGNA
FL
01
—
JMZY9
FL BCBS
FL
Enumeration date
06/14/2012
Last updated
08/20/2018
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