Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 0101030309 | VA |
NPI | 1093702813 |
---|---|
Provider Name | Thomas Earl Wheeler III |
First Address | Fredericksburg, VA 22401-4490 |
Second Address | Fredericksburg, VA 22401-4490 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 21/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B08478 | (02) |