Provider Demographics
NPI:1750352076
Name:WHEELER, SARA LYN (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:LYN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:491 JOHN YOUNG WAY
Mailing Address - Street 2:SUITE 210 MAIN LINE HEALTH CENTER
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2553
Mailing Address - Country:US
Mailing Address - Phone:484-565-8550
Mailing Address - Fax:610-280-1569
Practice Address - Street 1:491 JOHN YOUNG WAY
Practice Address - Street 2:SUITE 210 MAIN LINE HEALTH CENTER
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2553
Practice Address - Country:US
Practice Address - Phone:484-565-8550
Practice Address - Fax:610-280-1569
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055345L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001531359Medicaid
PW232359401OtherMAIN LINE HEALTHCARE
PA001531359Medicaid
PW232359401OtherMAIN LINE HEALTHCARE