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General NPI Number Information
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NPI Number | 1437847837
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Entity Type | Organization
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Legal Business Name | WISEMD
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 11/16/2024
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Provider Practice Location Address
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Address Line | 1111 W 4TH ST
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City | MADERA
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State | CA
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Zip | 93637-4474
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Country | US
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Telephone | 516-467-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 W 4TH ST
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City | MADERA
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State | CA
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Zip | 93637-4474
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. TABISH AFTAB NAZ
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Credential | MD
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Telephone | 516-467-9393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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