Wiseman, Dana
Wiseman, Dana is an individual health care provider with primary practice located at 40 Mansfield Ave , Willimantic CT 06226-2018. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wiseman, Dana can be contacted via phone (860) 450-7471.Contact Information
Primary practice address
40 Mansfield Ave
Willimantic CT 06226-2018
Phone: (860) 450-7471
Fax: (860) 450-0213
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 29768 | Connecticut |
Profile Details
| NPI number | 1811930795 |
|---|---|
| LBN Legal business name | Wiseman, Dana |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Mar 7th, 2023 - 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 | 1811930795 | NPPES |
| Connecticut | Other | 01002768CT06 | ANTHEM BLUE CROSS & BLUE |
| Connecticut | Other | 722627 | ANTHEM BLUE CROSS & BLUE |
| Connecticut | Other | HAP281 | ANTHEM BLUE CROSS & BLUE |
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