Healthcare Provider Details

I. General information

NPI: 1487661161
Provider Name (Legal Business Name): DARREN THOMAS WHEELER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 BURNHAM AVENUE ASSOCIATED PATHOLOGISTS, CHARTERED
LAS VEGAS NV
89119
US

IV. Provider business mailing address

4230 BURNHAM AVENUE ASSOCIATED PATHOLOGISTS, CHARTERED
LAS VEGAS NV
89119
US

V. Phone/Fax

Practice location:
  • Phone: 702-733-7866
  • Fax: 702-792-1319
Mailing address:
  • Phone: 702-733-7866
  • Fax: 702-733-8862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number10838
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: