Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 31512 | MN |
Y | 2080P0214X | Pediatric Pulmonologist | 31512 | MN |
NPI | 1417959362 |
---|---|
Provider Name | William B Wheeler |
First Address | Minneapolis, MN 55404-4289 |
Second Address | Minneapolis, MN 55404-4289 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 12/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E28250 | (02) | MN |