Wice, Martin B

Wice, Martin B is an individual health care provider with primary practice located at 4921 Parkview Pl , Saint Louis MO 63110-1032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Wice, Martin B can be contacted via phone (314) 362-4503.

Contact Information

Primary practice address
4921 Parkview Pl Saint Louis MO 63110-1032
Phone: (314) 362-4503
Fax: (314) 362-4566
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X R3G96 Missouri

Profile Details

NPI number 1972564375
LBN Legal business name Wice, Martin B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Jan 30th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972564375 NPPES
Illinois MEDICAID ENROLLED

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