Provider Demographics
NPI:1659503977
Name:WHEELER, NOAH JAMES (MA)
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:JAMES
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 MARBLE AVE NE APT D
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7924
Mailing Address - Country:US
Mailing Address - Phone:505-417-4271
Mailing Address - Fax:
Practice Address - Street 1:8101 MARBLE AVE NE APT D
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7924
Practice Address - Country:US
Practice Address - Phone:505-417-4271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide