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NPI Code Detail

MEDICARE: MICHAEL G WISSLER DO

MEDICARE:   MICHAEL G WISSLER  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician05010543LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497741094
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL G WISSLER DO
Provider Business Mailing Address
First Line : 5300 KIDSPEACE DR
Second Line :
City : OREFIELD
State : PA
Zip : 18069-2044
Country : US
Telephone Number : 610-799-8853
Fax Number : 610-799-8001
Provider Business Practice Location Address
First Line : 5300 KIDSPEACE DR
Second Line : KIDSPEACE NATIONAL CENTERS, INC.
City : OREFIELD
State : PA
Zip : 18069-2044
Country : US
Telephone Number : 610-799-8853
Fax Number : 610-799-8001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 07/21/2022

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Directions to “ MICHAEL G WISSLER DO” Practice Location

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