IndividualActive
Stuart Wise, M.D.
NPI 1154582443 · Reproductive Endocrinology Physician · Provo, UT
Provider details
- NPI number
- 1154582443
- Entity type
- Individual
- Primary specialty
- Reproductive Endocrinology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 161107-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1579 Willow Ln
Provo, UT 84604-2804
Phone: (801) 722-4678
Approximate (ZIP-level) locationGet directions
Mailing address
1579 Willow Ln
Provo, UT 84604-2804
Registry dates
- Enumerated
- 2008-06-19
- Last updated
- 2008-06-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.