Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 053208 | GA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 28650 | SC |
NPI | 1053348060 |
---|---|
Provider Name | Sarah K Wise |
First Address | Atlanta, GA 30322-0001 |
Second Address | Atlanta, GA 30322-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 24/01/2022 |