Provider Demographics
NPI:1104800382
Name:WHEELER, ROBERT EARL (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EARL
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CORDUROY RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2724
Mailing Address - Country:US
Mailing Address - Phone:603-673-8248
Mailing Address - Fax:603-672-5775
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:CATHOLIC MEDICAL CENTER
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102
Practice Address - Country:US
Practice Address - Phone:603-663-6478
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7423207P00000X
MA46316207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE0914Medicare UPIN