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Individual

ROBERT DAVID WISSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-2663
(573) 884-4608
Mailing address
5400 KENNEDY AVE, CINCINNATI, OH 45213-2664
(513) 281-3400

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2019033514
MO
2085R0202X
Diagnostic Radiology Physician
35-08-3106
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2426726
OH
Enumeration date
07/03/2006
Last updated
09/12/2022
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