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NPI Code Detail

MEDICARE: ERIC ANDREW WHEATLEY MD

MEDICARE: ERIC ANDREW WHEATLEY MD
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
1208M00000XHospitalist Physician4301070291MI
2208000000XPediatrics Physician4301070291MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2700H161150OTHERBLUE SHIELD

General Provider Information

NPI Number : 1356307730
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC ANDREW WHEATLEY MD
Provider Business Mailing Address
First Line : 24 FRANK LLOYD WRIGHT DR
Second Line : PO BOX 0446 LOBBY J
City : ANN ARBOR
State : MI
Zip : 48105-9484
Country : US
Telephone Number : 734-747-6766
Fax Number : 734-222-3100
Provider Business Practice Location Address
First Line : 4350 JACKSON RD
Second Line : STE 100
City : ANN ARBOR
State : MI
Zip : 48103-1889
Country : US
Telephone Number : 734-971-9344
Fax Number : 734-971-2303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 12/28/2016

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1548238769 — DR. WILLIAM CHAMNESS M.D.
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1831168947 — DR. MATTHEW WAIER M.D.
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48103-1889
Practice Phone: 734-971-9344
Practice Fax: 734-971-2303
1942279120 — DR. MICHAEL KUCERA M.D.
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4350 JACKSON RD , SUITE 100
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48103-1889
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Practice Fax: 734-971-2303
1164487963 — WENDY ROBERTS M.D.
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4350 JACKSON RD , SUITE 100
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48103-1889
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1164480141 — DR. MICHAEL I BRUDERLY M.D.
Practice Location Address:
4350 JACKSON RD , SUITE 200
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48103-1889
Practice Phone: 734-761-2581
Practice Fax: 734-761-9540

Directions to “ ERIC ANDREW WHEATLEY MD” Practice Location

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