Wisotsky, Philip

Wisotsky, Philip is an individual health care provider with primary practice located at 11350 Pembrooke Sq Ste 311 , Waldorf MD 20603-4809. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wisotsky, Philip can be contacted via phone (301) 870-0660.

Contact Information

Primary practice address
11350 Pembrooke Sq Ste 311 Waldorf MD 20603-4809
Fax: (301) 932-8310
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X D18545 Maryland
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D18545 Maryland

Profile Details

NPI number 1508862509
LBN Legal business name Wisotsky, Philip
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Nov 19th, 2021 - about 3 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 1508862509 NPPES
Maryland MEDICAID 960821400
Maryland Other 110167788

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