NPI 1063975423

Charles Edward Wiseman

Practitioner Private Vehicle Blue Springs, MO

Practice location

Address: 8091 SW 4th St, Blue Springs, MO 64014-7846
Phone: (314) 496-3230

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Registry record

NPI: 1063975423
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Apr 2019
Record last updated: 11 Apr 2019

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.