DARYL D WISDOM


Address: 10015 Cascade Rd Se, Lowell, MI 49331-9529
Phone: 6168687551

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 10015 CASCADE RD SE
City LOWELL
State MI
Zip Code 49331-9529

Providers in the same location

NPI Name Taxonomy Address Enumeration
1316086887 Daryl Wisdom Md Pllc Preventive Medicine 10015 Cascade Rd Se, Lowell, MI 49331-9529 2007-02-05

Providers in the same zip code

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 Information

Taxonomy Code 207PE0004X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine
Specialization Emergency Medical Services

Taxonomy Definition

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.

Providers in the same taxonomy and state

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

Competitor

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City LOWELL
Zip Code 49331

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Dataset Information

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.

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