Individual
JAY B WISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 N SENATE BLVD, INDIANAPOLIS, IN 46202-1228
(317) 944-5000
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01073447A
IN
207RN0300X
Nephrology Physician
35-043263
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224359
UNISON
OH
01
—
000000539618
ANTHEM
OH
05
—
0399304
—
OH
01
—
0640748
AETNA
OH
01
—
10001166
RAILROAD MEDICARE
OH
05
—
201206880
—
IN
01
—
364142
WELLCARE
OH
01
—
741808
BUCKEYE
OH
01
—
P00449244
RAILROAD MEDICARE
OH
Enumeration date
07/20/2006
Last updated
03/15/2025
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