Provider Demographics
NPI:1174786404
Name:WING AND WHEELER MD PA
Entity type:Organization
Organization Name:WING AND WHEELER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-278-2515
Mailing Address - Street 1:250 DIXIE BLVD
Mailing Address - Street 2:#102
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3857
Mailing Address - Country:US
Mailing Address - Phone:561-278-2515
Mailing Address - Fax:561-243-2130
Practice Address - Street 1:250 DIXIE BLVD
Practice Address - Street 2:#102
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3857
Practice Address - Country:US
Practice Address - Phone:561-278-2515
Practice Address - Fax:561-243-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0031686207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062055600Medicaid
1750385779OtherMEDICARE NPI (MICHAEL K WHEELER MD)
1750385779OtherMEDICARE NPI (MICHAEL K WHEELER MD)