William Rex Wiseman, DO
Pathology, Anatomic Pathology & Clinical Pathology in Rockledge, FL. Individual provider (NPI-1).
NPI number1417282997
StatusActive
Last updated in NPPESAug 26, 2019
Details
- NPI
- 1417282997
- Entity type
- Individual (NPI-1)
- Name
- William Rex Wiseman
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 16, 2009
- Last updated
- Aug 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | OS15712 | FL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 5101018518 | MI |
Practice location
110 Longwood AveRockledge, FL 32955-2828
Phone 321-636-2211
Mailing address
1500 E Medical Center DrAnn Arbor, MI 48109-5000
Phone 734-764-3270 · Fax 734-936-7361
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