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NPI Code Detail

MEDICARE: DR. ALAN H. WISEMAN MD

MEDICARE:  DR. ALAN H. WISEMAN  MD
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
1207RC0000XCardiovascular Disease Physician015911ME

General Provider Information

NPI Number : 1629049200
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALAN H. WISEMAN MD
Provider Business Mailing Address
First Line : 43 WHITING HILL RD STE 300
Second Line :
City : BREWER
State : ME
Zip : 04412-1006
Country : US
Telephone Number : 207-973-5035
Fax Number :
Provider Business Practice Location Address
First Line : 1 NORTHEAST DR
Second Line :
City : BANGOR
State : ME
Zip : 04401-4332
Country : US
Telephone Number : 207-275-3800
Fax Number : 207-275-3836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/02/2021

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Directions to “ DR. ALAN H. WISEMAN MD” Practice Location

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