Dr. Phillip Gregory Wise, M.D.
Urology in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1124124086
StatusActive
Last updated in NPPESJan 30, 2024
Details
- NPI
- 1124124086
- Entity type
- Individual (NPI-1)
- Name
- Dr. Phillip Gregory Wise
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2006
- Certification date
- Jan 30, 2024
- Last updated
- Jan 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | 4301078939 | MI | Yes |
Practice location
25 Michigan St NeSuite 3300
Grand Rapids, MI 49503-2515
Phone 616-459-4171 · Fax 616-459-0044
Mailing address
20952 E 12 Mile Rd Ste 200Saint Clair Shores, MI 48081-3203
Phone 586-771-4820
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