Provider Demographics
NPI:1093702813
Name:WHEELER, THOMAS EARL III (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EARL
Last Name:WHEELER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1201 SAM PERRY BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4490
Mailing Address - Country:US
Mailing Address - Phone:540-361-2922
Mailing Address - Fax:540-361-2927
Practice Address - Street 1:1201 SAM PERRY BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4490
Practice Address - Country:US
Practice Address - Phone:540-361-2922
Practice Address - Fax:540-361-2927
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101030309207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B08478Medicare UPIN