Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 7035A | WY |
NPI | 1013008416 |
---|---|
Provider Name | Dr. David B Wheeler |
First Address | Casper, WY 82601-2955 |
Second Address | Casper, WY 82601-2955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 17/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121198600 | (05) | WY |
I28304 | (02) |