Provider Demographics
NPI:1982817151
Name:WISEMAN, ADRIANA SILVIA (OD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:SILVIA
Last Name:WISEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 15189
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20825-5189
Mailing Address - Country:US
Mailing Address - Phone:240-203-9333
Mailing Address - Fax:240-319-7376
Practice Address - Street 1:9160 BELVOIR WOODS PKWY
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-2703
Practice Address - Country:US
Practice Address - Phone:240-203-9333
Practice Address - Fax:240-319-7376
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP1000262152W00000X, 152WL0500X
VA0601001497152W00000X, 152WL0500X
MDTA988152WL0500X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152W00000XEye and Vision Services ProvidersOptometrist