Individual
MATTHEW AMOS WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
520 THURGOOD MARSHALL HWY STE B, KINGSTREE, SC 29556-4108
(846) 355-5628
(843) 355-5616
Mailing address
360 N IRBY ST, FLORENCE, SC 29501-2808
(843) 667-9414
(843) 667-9414
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24626
SC
Other
Enumeration date
01/28/2021
Last updated
04/01/2021
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