Provider Demographics
NPI:1376530683
Name:WHEELER, SEAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:M
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11755 W 112TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2742
Mailing Address - Country:US
Mailing Address - Phone:913-469-0503
Mailing Address - Fax:913-338-1311
Practice Address - Street 1:11725 W 112TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2761
Practice Address - Country:US
Practice Address - Phone:913-469-5579
Practice Address - Fax:913-338-1311
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04273572081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G36233Medicare UPIN
KSKA2040050Medicare PIN
553D844AMedicare ID - Type Unspecified