Mark A Wyse, M.D.
Family Medicine in Phoenix, AZ. Individual provider (NPI-1).
NPI number1346200060
StatusActive
Last updated in NPPESMar 29, 2024
Details
- NPI
- 1346200060
- Entity type
- Individual (NPI-1)
- Name
- Mark A Wyse
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2006
- Certification date
- Sep 28, 2023
- Last updated
- Mar 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 12165 | AZ | Yes |
Practice location
4600 E Shea Blvd Ste 100Phoenix, AZ 85028-6031
Phone 602-955-8700 · Fax 602-553-8142
Mailing address
4600 E Shea Blvd Ste 100Phoenix, AZ 85028-6031
Phone 602-955-8700 · Fax 602-553-8142
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