Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD00023204 | WA |
NPI | 1235280140 |
---|---|
Provider Name | Bruce R. Wheeler |
First Address | Seattle, WA 98124-1584 |
Second Address | Tacoma, WA 98405-4265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 15/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8141376 | (05) | WA |
F35722 | (02) | WA |