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Individual

DOUGLAS M WISNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4060 BUTLER PIKE, SUITE 100, PLYMOUTH MEETING, PA 19462-1560
(215) 836-1290
(215) 233-3421
Mailing address
4060 BUTLER PIKE, SUITE 100, PLYMOUTH MEETING, PA 19462-1560
(215) 836-1290
(215) 233-3421

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD444936
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1027305650001
PA
Enumeration date
06/24/2008
Last updated
05/31/2017
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