Larry Keith Wise is a Psychiatry in Salisbury, Maryland. Larry Keith Wise practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for Larry Keith Wise is 1407982721. The last update date is 2011-04-28.
Larry Keith Wise's current location address is 2336 Goddard Pkwy, Salisbury, Maryland. You can contact this provider via phone number 4103346961 and fax number 4103346362. The mailing address for Larry Keith Wise is 2336 Goddard Pkwy, Salisbury, Maryland. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry Keith Wise |
|---|---|
| Address | 2336 Goddard Pkwy, Salisbury, Maryland |
| Phone Number | 4103346961 |
| Fax Number | 4103346362 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1407982721 |
|---|---|
| Provider Enumeration Date | 2007-02-23 |
| Last Updated Date | 2011-04-28 |
Provider Mailing Address Detail
| Address | 2336 Goddard Pkwy |
|---|---|
| City | Salisbury |
| State | Maryland (MD) |
| Post Code | 218011126 |
| Phone Number | 4103346961 |
| Fax Number | 4103346362 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | MD26174 |
|
Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 930593249 | OR | GROUP TAX ID # | |
| 609550001 | MD | -- | |
| 609550002 | MD | -- | |
| 1225016561 | OR | GROUP NPI # | |
| 609550004 | MD | -- | |
| LM49EA | MD | CAREFIRST BCBS LOCAL | |
| R968 | MD | CAREFIRST BCBS |
Post Comment/ Review Below
What is the Larry Keith Wise's unique identification number?
The Larry Keith Wise has been assigned the NPI (National Provider Identifier) Number 1407982721 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where Larry Keith Wise's facilities are situated?
The facilities of Larry Keith Wise are physically located at the following address: 2336 Goddard Pkwy, Salisbury, MD, 218011126.
What is the Larry Keith Wise's specialty and taxonomy code?
The Larry Keith Wise's specialty is Psychiatry, and the corresponding taxonomy code is 2084P0800X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1407982721 to Larry Keith Wise?
The Centers for Medicare & Medicaid Services originally issued the 1407982721 to Larry Keith Wise on 2007-02-23.
As of what date were the details pertaining to Larry Keith Wise last refreshed?
The information related to the Larry Keith Wise, including its address, specialty, and other relevant details, was last updated on 2011-04-28.
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