Individual
DR. DAVID S. WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MDH8963
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
H8963
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063CN
BLUE CROSS ID NUMBER
TX
01
—
060050641
RAILROAD MEDICARE NUMBER
TX
05
—
113351401
—
TX
Enumeration date
06/13/2006
Last updated
11/29/2016
Update your record
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