MEDICARE: RENEE A. WHEELER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	222295	NY

General Provider Information

NPI Number	:	1285746867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE A. WHEELER D.O.

Provider Business Mailing Address
First Line	:	1247 DONALD LEE HOLLOWELL PKWY NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-6657
Country	:	US
Telephone Number	:	404-616-2265
Fax Number	:

Provider Business Practice Location Address
First Line	:	1247 DONALD LEE HOLLOWELL PKWY NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-6657
Country	:	US
Telephone Number	:	404-616-2265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/09/2023

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