Organization
HEALTHWISE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KALVIN JOHN WILEY M.D. (PHYSICIAN CEO)
(410) 821-8087
Entity
Organization
Contact information
Practice address
8501 LASALLE RD, SUITE #102, TOWSON, MD 21286-5914
(410) 821-8087
(410) 821-9001
Mailing address
8501 LASALLE RD, SUITE #102, TOWSON, MD 21286-5914
(410) 821-8087
(410) 821-9001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M49995
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6813038 00
—
MD
01
—
6902000000KFD6
CAREFIRST BCBS
MD
01
—
J203
GHMSI
MD
01
—
J2030000
BCBS FEDERAL
MD
Enumeration date
08/05/2007
Last updated
08/05/2007
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