Wise, Loren M

Wise, Loren M is an individual health care provider with primary practice located at 5629 Stadium Dr Suite D, Kalamazoo MI 49009-1952. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wise, Loren M can be contacted via phone (269) 372-5701.

Contact Information

Primary practice address
5629 Stadium Dr Suite D Kalamazoo MI 49009-1952
Phone: (269) 372-5701
Fax: (269) 372-5702
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301078298 Michigan

Profile Details

NPI number 1972573442
LBN Legal business name Wise, Loren M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Oct 10th, 2014 - about 10 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 1972573442 NPPES
Michigan Other CA4396 RAILROAD MEDICARE
Michigan MEDICAID 4635894 RAILROAD MEDICARE

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