Provider Demographics
NPI:1205967924
Name:WHEELING, JAMES ROBERT
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:WHEELING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:ROBERT
Other - Last Name:WHEELING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:432 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2046
Mailing Address - Country:US
Mailing Address - Phone:607-433-2684
Mailing Address - Fax:607-432-8781
Practice Address - Street 1:432 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2046
Practice Address - Country:US
Practice Address - Phone:607-433-2684
Practice Address - Fax:607-432-8781
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186971207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01278995Medicaid
NY10021906OtherCDPHP #
NY699163OtherMVP MED #
NY699164OtherMVP CARDIOL #
NYP00030226OtherRR MEDICARE
NYP00030226OtherRR MEDICARE
NYP00030226OtherRR MEDICARE
NY52926BMedicare PIN