Provider Demographics
NPI:1932262847
Name:WHEELER, ANGELA (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MILLERSPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5434
Mailing Address - Country:US
Mailing Address - Phone:888-830-4255
Mailing Address - Fax:615-468-1928
Practice Address - Street 1:2022 KELLE DR
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-8708
Practice Address - Country:US
Practice Address - Phone:219-395-2200
Practice Address - Fax:219-983-1837
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01044117207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000203751OtherPROVIDER BCBS NUMBER
IN110219044OtherRAILROAD PROVIDER NUMBER
IN000000203751OtherPROVIDER BCBS NUMBER
ING17565Medicare UPIN