Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 02002655A | IN |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5101014375 | MI |
NPI | 1003818766 |
---|---|
Provider Name | Michael T Wheeler |
First Address | East Lansing, MI 48823-2740 |
Second Address | East Lansing, MI 48823-2740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 20/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H87618 | (02) | IN |