Individual
DR. WISAM GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2300 HAGGERTY RD, SUITE 2100, WEST BLOOMFIELD, MI 48323-2184
(248) 624-7246
(248) 624-2597
Mailing address
32255 NORTHWESTERN HWY STE 165, FARMINGTON HILLS, MI 48334-1505
(248) 735-8272
(248) 735-7276
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
5315031019
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
L1130895
MI
Other
Enumeration date
06/14/2007
Last updated
09/21/2023
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