MEDICARE: CHIKOTI MIBENGE WHEAT 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
1	207N00000X	Dermatology Physician	D0082849	MD

General Provider Information

NPI Number	:	1619210598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIKOTI MIBENGE WHEAT MD

Provider Business Mailing Address
First Line	:	PO BOX 23329
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-3329
Country	:	US
Telephone Number	:	667-375-3376
Fax Number	:	443-249-7437

Provider Business Practice Location Address
First Line	:	7671 QUARTERFIELD RD STE 200A
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-4407
Country	:	US
Telephone Number	:	443-351-3376
Fax Number	:	410-582-9155

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

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	03/26/2026

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