Dr. Sean Robert Wise
Family Doctor - Sports Medicine
2817 Reilly St Family Medicine Residency Clinic
Fort Bragg
, North Carolina 28310-7324
Dr. Sean Robert Wise
Family Doctor - Sports Medicine
2817 Reilly St Family Medicine Residency Clinic
Fort Bragg
, North Carolina 28310-7324
(910) 907-9619
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Sean Robert Wise
- 9300 Dewitt Loop
- Fort Belvoir, VA
- Zip : 22060-5285
- Phone : (910) 907-9619
Second Address
- Dr. Sean Robert Wise
- 2817 Reilly St Family Medicine Residency Clinic
- Fort Bragg, NC
- Zip : 28310-7324
- Phone : (910) 907-9619
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 2018-02819 | NC |
National Provider Identifier
| NPI | 1083896534 |
|---|---|
| Provider Name | Dr. Sean Robert Wise |
| First Address | Fort Belvoir, VA 22060-5285 |
| Second Address | Fort Bragg, NC 28310-7324 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/11/2007 |
| Last Update Date | 10/06/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| VAD 000 | (02) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.