Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 21409 | AZ |
NPI | 1164468328 |
---|---|
Provider Name | Dr. Mark D. Wheeler |
First Address | Tucson, AZ 85724-0001 |
Second Address | Tucson, AZ 85724-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 08/07/2007 |