Organization
GREG A. WISE, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG A. WISE M.D. (PHYSICIAN)
(614) 836-2273
Entity
Organization
Contact information
Practice address
4100 VENTURE PL, GROVEPORT, OH 43125-9206
(614) 836-2273
(614) 836-9320
Mailing address
4100 VENTURE PL, GROVEPORT, OH 43125-9206
(614) 836-2273
(614) 836-9320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
055595
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0739866
—
OH
Enumeration date
05/02/2007
Last updated
08/22/2020
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