Provider Demographics
NPI:1629362207
Name:WHEELER, SAMANTHA MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:MARIE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:MARIE
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1139 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-5502
Mailing Address - Country:US
Mailing Address - Phone:912-303-4200
Mailing Address - Fax:912-790-2701
Practice Address - Street 1:1139 LEXINGTON AVE
Practice Address - Street 2:STE A
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-5502
Practice Address - Country:US
Practice Address - Phone:912-303-4200
Practice Address - Fax:912-790-2701
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant