Provider Demographics
NPI:1780665836
Name:WHEELER, CRAIG A (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1050
Practice Address - Street 1:6465 MILLENNIUM
Practice Address - Street 2:SUITE 100
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-7831
Practice Address - Country:US
Practice Address - Phone:517-367-5220
Practice Address - Fax:517-367-5245
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301038070207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI204118OtherMCLAREN HEALTH PLAN
MI7064136OtherAETNA
MI0400216OtherPHYSICIANS HEALTH PLAN
MI1103321471OtherBLUE CROSS BLUE SHIELD
MIA77718OtherHEALTH NET FEDSERVICES
MI204118OtherHEALTH ADVANTAGE NETWORK
MI4130531Medicaid
MI204118OtherHEALTH ADVANTAGE NETWORK
MIA77718Medicare UPIN