Healthcare Provider Details

I. General information

NPI: 1982796579
Provider Name (Legal Business Name): KIRKE W WHEELER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST MEMORIAL BUILDING, WEST, GROUND FLO
CONCORD NH
03301-2548
US

IV. Provider business mailing address

246 PLEASANT ST MEMORIAL BUILDING, WEST, GROUND FLO
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-6010
  • Fax: 603-224-6094
Mailing address:
  • Phone: 603-224-6010
  • Fax: 603-224-6094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number7139
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number7139
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: