Provider Demographics
NPI:1699734558
Name:WHEELER, LARA K (MD)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:K
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:K
Other - Last Name:SCHEINBLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:841 CENTRAL ST STE 106
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2026
Mailing Address - Country:US
Mailing Address - Phone:603-934-1464
Mailing Address - Fax:603-924-6037
Practice Address - Street 1:841 CENTRAL ST STE 101
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2053
Practice Address - Country:US
Practice Address - Phone:603-934-1464
Practice Address - Fax:603-934-1465
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10529208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3074758Medicaid
G92429Medicare UPIN
NH3074758Medicaid