Provider Demographics
NPI:1912096322
Name:IN-HOUSE INTERNIST LLC
Entity Type:Organization
Organization Name:IN-HOUSE INTERNIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-227-7399
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802-0749
Mailing Address - Country:US
Mailing Address - Phone:419-227-7399
Mailing Address - Fax:419-229-0123
Practice Address - Street 1:750 W HIGH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-2969
Practice Address - Country:US
Practice Address - Phone:419-227-7399
Practice Address - Fax:419-229-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2325175Medicaid
OH9314891Medicare ID - Type Unspecified