Provider Demographics
NPI:1194855841
Name:WHEELER, DANA WESLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:WESLEY
Last Name:WHEELER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:156 TRADD ST APT B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-2460
Mailing Address - Country:US
Mailing Address - Phone:843-767-6756
Mailing Address - Fax:843-572-7282
Practice Address - Street 1:2150 NORTHWOODS BLVD UNIT E-2
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4043
Practice Address - Country:US
Practice Address - Phone:843-572-5738
Practice Address - Fax:843-572-7282
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0872152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist