DARYL D WISDOM (NPI# 1205849866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205849866 |
Entity Type | Individual |
Full Name | DARYL D WISDOM |
Credential | MD |
Practice Address |
10015 Cascade Rd Se Lowell MI 49331-9529 |
Practice Telephone | 6168687551 |
Practice Fax Number | 6168687321 |
Mailing Telephone | 6168687551 |
Mailing Fax Number | 6168687321 |
Enumeration Date | 2006-08-14 |
Last Update Date | 2016-10-28 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
4301048819 | MI | Allopathic & Osteopathic Physicians |
N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
4301048819 | MI | Allopathic & Osteopathic Physicians |
Street Address |
10015 CASCADE RD SE |
City | LOWELL |
State | MI |
Zip Code | 49331-9529 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316086887 | Daryl Wisdom Md Pllc | Preventive Medicine | 10015 Cascade Rd Se, Lowell, MI 49331-9529 | 2007-02-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295173771 | Heather Marie Jones | Optometrist | 915 W. Green St Ste 101, Hastings, MI 49331 | 2013-06-06 |
1841474012 | Mark Frederic Peterson I | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3351 36th St, Grand Rapids, MI 49331 | 2007-12-24 |
1184732323 | Alivio Corporation | Durable Medical Equipment & Medical Supplies | 901 W. Main Street, Suite C, Lowell, MI 49331 | 2006-08-28 |
1740707637 | Parker Liu | Pharmacist | 11980 Fulton St E, Lowell, MI 49331 | 2017-08-23 |
1962482653 | Martin D Vredenburg | Dentist | 1150 N Hudson St, Lowell, MI 49331-1000 | 2006-01-19 |
1407140197 | Spectrum Health Primary Care Partners | Internal Medicine | 1150 N Hudson St, Lowell, MI 49331-1000 | 2011-05-31 |
1508034141 | Lowell Medical Specialists, PC | Internal Medicine | 1150 N Hudson St, Lowell, MI 49331-1000 | 2008-02-18 |
1740660315 | Patricia Sellner | Specialist/Technologist | 990 N Hudson St, Lowell, MI 49331-1006 | 2015-06-08 |
1508327370 | Lydia Joan Gerard | Registered Nurse | 1060 Hunt St, Lowell, MI 49331-1079 | 2019-03-26 |
1154847184 | Family Dentistry of Lowell | Dentist | 147 N Center St, Lowell, MI 49331-1207 | 2017-08-22 |
Find all providers in zip 49331 |
Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770059529 | Zachary Kenneth Brown | Emergency Medicine | 906 S Crapo St, Mt Pleasant, MI 48858-3662 | 2018-10-19 |
1356778286 | Donald Smith Pllc | Emergency Medicine | 1905 N Hammond Lake Dr, Bloomfield Hills, MI 48302-0139 | 2013-10-10 |
1346486222 | Flushing Road Urgent Care PC | Emergency Medicine | 1301 Flushing Rd, Flint, MI 48504-4710 | 2008-12-26 |
1184897209 | Donnell Stephen Newman Jr. | Emergency Medicine | 1460 Lakepointe St, Grosse Pointe Park, MI 48230-1016 | 2008-04-09 |
1134131683 | Rick L Holland | Emergency Medicine | 8333 Felch Ave, Zeeland, MI 49464 | 2006-08-13 |
1760493472 | Katherine J Pitus | Emergency Medicine | 118000 E Twelve Mile Rd, Er Department, Warren, MI 48093 | 2006-08-10 |
1952319881 | Robert Prodinger | Emergency Medicine | 9825 W Gull Lake Dr, Richland, MI 49083-9543 | 2006-08-04 |
1164436671 | James Barry Nolin | Emergency Medicine | 1805 Wild Dr, Richland, MI 49083-9361 | 2006-07-28 |
1518987072 | Trace Dotson | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-07-20 |
1740211655 | Chris Deva Samy | Emergency Medicine | 80 Grosse Pines Dr, Rochester Hills, MI 48309-1828 | 2006-07-06 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DARYL D WISDOM.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.