Individual
MELISSA JO WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
159 S ENGLISH STATION RD, LOUISVILLE, KY 40245-3996
(502) 753-0056
(502) 756-0626
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9146
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
43415
KY
207N00000X
Dermatology Physician
MT190084
PA
Other
Enumeration date
05/28/2008
Last updated
03/17/2021
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