NPI 1619076056
Paul Edward Wise, MD
Colon & Rectal Surgery · Saint Louis, MO
Active in the CMS NPI RegistryNot on the OIG exclusion listchecked Oct 16, 2026, 4:12 am EDT
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Paul Edward Wise, MD is a health care provider (Colon & Rectal Surgery) in Saint Louis, Missouri with National Provider Identifier (NPI) 1619076056. The NPI was issued on Sep 22, 2006 and the registry record was last updated on Apr 17, 2025. The registry lists 2 licenses in Missouri.
Registry record
- NPI
- 1619076056
- Type
- Individual (NPI-1)
- Primary specialty
- Colon & Rectal Surgery 208C00000X
- Practice location
- 4500 Forest Park Ave, Div Surg Colon/Rectal, 5th Fl
Saint Louis, MO 63108-2114 - Phone
- (314) 454-7177
- NPI issued
- Sep 22, 2006
- Registry record updated
- Apr 17, 2025
Specialties and licenses
| Specialty | Taxonomy code | License state | License |
|---|---|---|---|
| Colon & Rectal Surgery Primary | 208C00000X | Missouri | 2012011934 |
| Surgery | 208600000X | Missouri | 2012011934 |
Confirm license status and discipline with the state board (links in NPI Lookup).
Source: CMS National Plan and Provider Enumeration System (NPPES) and the HHS-OIG List of Excluded Individuals/Entities (list of Oct 9, 2026). Is this your record? Update it in NPPES or email info@2minutemedicine.com to have it hidden here.