Individual
DR. RICHARD CULWELL WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1151 MAY ST, HOOD RIVER, OR 97031-1526
(541) 387-8992
Mailing address
PO BOX 3390, PORTLAND, OR 97208-3390
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD168558
OR
208600000X
Surgery Physician
ML60093926
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500672454
—
OR
Enumeration date
04/13/2008
Last updated
03/25/2021
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