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
Phone: (301) 870-0660
Fax: (301) 932-8310
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508862509 | NPPES |
| Maryland | MEDICAID | 960821400 | |
| Maryland | Other | 110167788 |
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