Individual
JAIME CHRISTINE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 W MEETING ST, LANCASTER, SC 29720-2202
(803) 286-1214
(888) 507-9833
Mailing address
PO BOX 848886, BOSTON, MA 02284-8886
(904) 446-3451
(888) 507-9833
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2008-00306
NC
207Q00000X
Family Medicine Physician
Primary
MMD.36408MD
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NC1055
—
SC
Enumeration date
03/05/2007
Last updated
03/02/2015
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