DR. MATTHEW DAVID WISE (NPI# 1295944932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295944932 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW DAVID WISE |
| Credential | MD |
| Practice Address |
3800 Park Nicollet Blvd Minneapolis MN 55416-2527 |
| Mailing Address |
3800 Park Nicollet Blvd St Louis Park MN 55416-2527 |
| Practice Telephone | 9529931792 |
| Practice Fax Number | 9529931761 |
| Mailing Telephone | 9529931792 |
| Mailing Fax Number | 9529931761 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-12-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
57356 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477600641 | Matthew John Wise | Chiropractor | 190 Spring Dr, Saint Charles, MO 63303-3255 | 2007-01-03 |
| 1235107038 | Matthew Jay Wise | Obstetrics & Gynecology | 153 Pioneer Ln, Suite B, Bishop, CA 93514-2517 | 2006-03-09 |
| 1295394161 | Matthew Wise | Student in an Organized Health Care Education/Training Program | 331 Ne Thornton Pl, Seattle, WA 98125-8021 | 2019-06-13 |
| 1093075780 | Matthew Wise | Chiropractor | 2217 Carlisle Rd, York, PA 17408-4005 | 2012-05-29 |
| 1295949717 | Matthew L. Wise | Psychologist | 7330 Woodmont Ave, Bethesda, MD 20814-5354 | 2007-05-10 |
| 1245251263 | Matthew Whitten Wise | Surgery | 2820 Napoleon Ave, Suite 810, New Orleans, LA 70115-6969 | 2006-07-23 |
| 1497798714 | Matthew K Wise | Family Medicine | 1501 S Yale St, Bldg 2 Suite 150, Flagstaff, AZ 86001-7304 | 2006-06-14 |
| Street Address |
3800 PARK NICOLLET BLVD |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55416-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578099677 | Elizabeth Ann Johnson | Dietitian, Registered | 3800 Park Nicollet Blvd, International Diabetes Center, Minneapolis, MN 55416-2527 | 2017-05-10 |
| 1184005407 | Mary K Spencer | Dietitian, Registered | 3800 Park Nicollet Blvd, Minneapolis, MN 55416-2527 | 2015-06-11 |
| 1659775799 | Gay Castle | Dietitian, Registered | 3800 Park Nicollet Blvd, Minneapolis, MN 55416-2527 | 2014-10-17 |
| 1568781029 | Rebecca Ann Passi | Dietitian, Registered | 3800 Park Nicollet Blvd, 6s, Minneapolis, MN 55416-2527 | 2010-05-24 |
| 1821281338 | Matthew W Tsang | Dermatology | 3800 Park Nicollet Blvd, Dermatology and Dermatopathology, Minneapolis, MN 55416-2527 | 2007-08-20 |
| 1639242357 | Sharon L Duncan | Physical Therapist | 3800 Park Nicollet Blvd, Rehab Services, Minneapolis, MN 55416-2527 | 2006-11-17 |
| 1467556027 | Jennifer Mae Sexton | Psychiatry & Neurology | 3800 Park Nicollet Blvd, Minneapolis, MN 55416-2527 | 2006-09-12 |
| 1013021914 | Glenn Matfin | Internal Medicine | 3800 Park Nicollet Blvd, Minneapolis, MN 55416 | 2006-08-18 |
| 1467484014 | Alison K Adams | Dermatology | 3800 Park Nicollet Blvd, Minneapolis, MN 55416-2527 | 2006-07-06 |
| 1013994052 | Richard Sveum | Pediatrics | 3800 Park Nicollet Blvd, Minneapolis, MN 55416-2527 | 2005-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821380007 | Megan Marie Oberle | Pediatrics | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2011-05-06 |
| 1316247323 | Melinda June Rogers Ross Pierce | Pediatrics | 2530 Chicago Ave, Minneapolis, MN 55404-4289 | 2010-10-25 |
| 1578880746 | Eric Morris Bomberg | Pediatrics | 2512 S 7th St, Minneapolis, MN 55454 | 2010-04-28 |
| 1679617930 | Lynda E Polgreen | Pediatrics | 516 Delaware St Se, Pwb 13-214, Mmc 8404, Minneapolis, MN 55455-0356 | 2007-02-19 |
| 1295819498 | Anna Petryk | Pediatrics | 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455 | 2006-10-24 |
| 1053494542 | Kumud S Sane | Pediatrics | 516 Delaware St Se, Pwb 4th Floor, Room 4-100, Minneapolis, MN 55455-0356 | 2006-10-20 |
| 1407937766 | Angelica Badaru | Pediatrics | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750368247 | Martha L. Spencer | Pediatrics | 3800 Park Nicolett Blvd., Pediatric Endocrinology, St. Louis Park, MN 55416-2699 | 2005-12-27 |
| 1174515274 | Mary Jennifer Abuzzahab | Pediatrics | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2005-08-16 |
| 1255323358 | Krishna M Saxena | Pediatrics | Children's Specialty Clinic-diabetes/endocrinology-stpl, 347 North Smith Avenue, St Paul, MN 55102 | 2005-08-16 |
| 1023540473 | Sarah Jackson | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-04-03 |
| 1831518828 | Luong Doan | Pediatrics | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2014-04-07 |
| 1265788574 | Anoop Mohamed Iqbal | Pediatrics | 200 1st St Sw, 55905-, Rochester, MN 55905-0001 | 2012-07-24 |
| 1043574569 | Kannan Kasturi | Pediatrics | 400 E 3rd St, Duluth, MN 55805 | 2012-06-28 |
| 1124295761 | Zarlasht Amini | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2008-05-13 |
| 1457440380 | Christine L Ternand | Pediatrics | 347 Smith Ave N, Children's Hospitals and Clinics of Mn, Saint Paul, MN 55102-2387 | 2006-10-11 |
| 1215901699 | Aida N Lteif | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-02-14 |
| Find all providers with the same taxonomy | ||||
| City | MINNEAPOLIS |
| Zip Code | 55416 |
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| 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.