Individual
DR. RONALD S WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 RIBAUT RD, STE 30, BEAUFORT, SC 29902-5447
(843) 524-8171
(843) 525-6613
Mailing address
1055 RIBAUT RD, STE 30, BEAUFORT, SC 29902-5447
(843) 524-8171
(843) 525-6613
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4722
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020047288
RAILROAD MEDICARE
SC
05
—
047229
—
SC
Enumeration date
02/08/2006
Last updated
01/18/2010
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