Wisman, Paul Pence

Wisman, Paul Pence is an individual health care provider with primary practice located at 1011 E Jefferson St , Charlottesville VA 22902-5354. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wisman, Paul Pence can be contacted via phone (434) 296-9161.

Contact Information

Primary practice address
1011 E Jefferson St Charlottesville VA 22902-5354
Phone: (434) 296-9161
Fax: (434) 296-1036
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101049022 Virginia

Profile Details

NPI number 1235115650
LBN Legal business name Wisman, Paul Pence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 17th, 2005
Last updated Sep 29th, 2012 - about 14 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 1235115650 NPPES
Virginia Other 12211500001 SOUTHERN HEALTH
Virginia Other 010724 SOUTHERN HEALTH
Virginia Other 267258 SOUTHERN HEALTH
Virginia Other 333848 SOUTHERN HEALTH
Virginia MEDICAID 006725856 SOUTHERN HEALTH
Virginia Other 42728 SOUTHERN HEALTH

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