Individual
DR. DOUGLAS FENTON WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6836 COOKES HOPE RD, EASTON, MD 21601-8302
(410) 690-0975
Mailing address
6836 COOKES HOPE RD, EASTON, MD 21601-8302
(410) 690-0975
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0070552
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3514606
—
MI
Enumeration date
01/20/2006
Last updated
08/09/2020
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