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Brian W Wistow, MD
Diagnostic Ultrasound Physician in Modesto, California
NPI 1437109709

Brian W Wistow is a Diagnostic Ultrasound Physician based in Modesto, CA and is specialized in Diagnostic Ultrasound. Brian W Wistow practices in Modesto, CA and has the professional credentials of MD. The NPI Number for Brian W Wistow is 1437109709 and holds a License No. A33568 (California).

The current practice location address for Brian W Wistow is 600 Coffee Rd, Modesto, CA and can be reached out via phone at 209-524-1211. You can also correspond with Brian W Wistow through the mailing address at 600 COFFEE RD, MODESTO, CA - 95355-4201 (mailing address contact number: 209-524-1211).

Location: 600 Coffee Rd, Modesto, CA, 95355-4201
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437109709
Provider Name
Brian W Wistow
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
600 Coffee Rd, Modesto, CA, 95355-4201
Phone Number
209-524-1211
Fax Number
Provider Enumeration Date
05/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A335680 05 CA
institution
Provider Business Practice Location Address Details
Address
600 Coffee Rd
City
Modesto
State
California
Zip
95355-4201
Phone Number
209-524-1211
Fax Number
person
Provider Business Mailing Address Details
Address
600 Coffee Rd
City
Modesto
State
California
Zip
95355-4201
Phone Number
209-524-1211
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Body Imaging
Taxonomy
2085B0100X
License No.
A33568 (California)
Definition
A Radiology doctor of Osteopathy that specializes in Body Imaging.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
A33568 (California)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Ultrasound
Taxonomy
2085U0001X
License No.
A33568 (California)
Definition
A Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound.
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