Individual
SAMUEL A. WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3201 S MARYLAND PKWY, SUITE 218, LAS VEGAS, NV 89109-2441
(702) 893-0800
(702) 893-0109
Mailing address
3201 S MARYLAND PKWY, SUITE 218, LAS VEGAS, NV 89109-2441
(702) 893-0800
(702) 893-0109
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5908
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002461
—
NV
Enumeration date
01/10/2007
Last updated
12/06/2010
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