Provider Demographics
NPI:1649387028
Name:WISLER, PATRICIA L (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:WISLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 MCFARLAND LN
Mailing Address - Street 2:STE B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3628
Mailing Address - Country:US
Mailing Address - Phone:317-889-6551
Mailing Address - Fax:317-889-6651
Practice Address - Street 1:7825 MCFARLAND LN
Practice Address - Street 2:STE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-3628
Practice Address - Country:US
Practice Address - Phone:317-889-6551
Practice Address - Fax:317-889-6651
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045434174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200142090CMedicaid
ING60719Medicare UPIN