Individual
DOUGLAS C WISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 ALVORD PARK RD, TORRINGTON, CT 06790
(860) 482-8539
(860) 482-0258
Mailing address
245 ALVORD PARK RD, TORRINGTON, CT 06790
(860) 482-8539
(860) 482-0258
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
032872
CT
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
032872
CT
2086S0105X
Surgery of the Hand (Surgery) Physician
032872
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001328724
—
CT
01
—
010032872CT01
BC
CT
01
—
2205151
AETNA
CT
Enumeration date
05/22/2006
Last updated
06/17/2021
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