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Individual

ERIN WISMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
201 N HAMILTON ST, RICHMOND, VA 23221-2601
(804) 355-4358
(804) 213-0548
Mailing address
201 N HAMILTON ST, RICHMOND, VA 23221-2601
(804) 355-4358
(804) 213-0548

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101261443
VA
207Q00000X
Family Medicine Physician
MD15157
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101261443
VIRGINIA BOARD OF MEDICINE
RI
01
MD15157
RHODE ISLAND MEDICAL BOARD
RI
Enumeration date
06/11/2012
Last updated
07/21/2022
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