Blakely David Wise, PA

NPI #1396201935 in Cornelius, North Carolina

Provider Information

NPI Number: 1396201935
Entity Type: Individual
Name: Blakely David Wise, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Feb 19, 2019
Last Updated: Sep 25, 2025

Practice Location

Address: 20036 ZION AVE
Address 2: STE 100
City: Cornelius
State: North Carolina
ZIP Code: 28031-8435
Phone: (704) 801-7400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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