NPI 1053871004

Jeffrey Mark Wise, DO

Practitioner Anesthesiology Physician Plymouth, MN

Practice location

Address: 14700 28th Ave N STE 20, Plymouth, MN 55447-4876
Phone: (763) 559-3779
Fax: (763) 450-3986
Mailing address: PO Box 47159, Plymouth, MN 55447-0159

Registered specialties

Anesthesiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 73128 (MN)

Other Anesthesiology providers in Minnesota →

Registry record

NPI: 1053871004
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Mar 2019
Record last updated: 8 Feb 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.