Provider Demographics
NPI:1952312647
Name:WISHAM, ROBERT P (RPM)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:P
Last Name:WISHAM
Suffix:
Gender:M
Credentials:RPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PINEHURST RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805
Mailing Address - Country:US
Mailing Address - Phone:828-298-0750
Mailing Address - Fax:
Practice Address - Street 1:2299 HWY 70 EAST
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778
Practice Address - Country:US
Practice Address - Phone:828-686-5087
Practice Address - Fax:828-686-5209
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist