Wise, Phillip Gregory

Wise, Phillip Gregory is an individual health care provider with primary practice located at 25 Michigan St Ne Suite 3300, Grand Rapids MI 49503-2515. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Wise, Phillip Gregory can be contacted via phone (616) 459-4171.

Contact Information

Primary practice address
25 Michigan St Ne Suite 3300 Grand Rapids MI 49503-2515
Phone: (616) 459-4171
Fax: (616) 459-0044
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 4301078939 Michigan

Profile Details

NPI number 1124124086
LBN Legal business name Wise, Phillip Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Jan 30th, 2024 - about 10 months 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 1124124086 NPPES
Michigan MEDICAID 5217870

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