Provider Demographics
NPI:1053573147
Name:WISER, HERBERT J (MD)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:J
Last Name:WISER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1385 W MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9366
Mailing Address - Country:US
Mailing Address - Phone:920-433-9400
Mailing Address - Fax:920-455-9409
Practice Address - Street 1:1385 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9366
Practice Address - Country:US
Practice Address - Phone:920-433-9400
Practice Address - Fax:920-455-9409
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK154907208800000X
IL036132577208800000X
WI65930-20208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology