MEDICARE: EDEN WHEELER M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	04-25286	KS
2	208100000X	Physical Medicine & Rehabilitation Physician	105924	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00226196	OTHER	KS	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	48-1225035	OTHER	AETNA
2	481225035	OTHER	CIGNA
3	2135088	OTHER	BC/BS OF KC
4	104046	OTHER	BC/BS OF KS
5	222843	OTHER	COVENTRY

General Provider Information

NPI Number	:	1669422473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDEN WHEELER M.D.

Provider Business Mailing Address
First Line	:	9233 WARD PKWY
Second Line	:	SUITE 362
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-3366
Country	:	US
Telephone Number	:	816-442-7141
Fax Number	:	816-442-7143

Provider Business Practice Location Address
First Line	:	9233 WARD PKWY
Second Line	:	SUITE 362
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-3366
Country	:	US
Telephone Number	:	816-442-7141
Fax Number	:	816-442-7143

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	06/13/2014

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1871775437 — DR. RICHARD STEPHEN GILMAN DDS, MS
Practice Location Address:

9233 WARD PKWY , SUITE 330
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1285804427 — MS. SUSAN NADINE EEDS L.P.C., ED.S., M.A.
Practice Location Address:

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Directions to “ EDEN WHEELER M.D.” Practice Location

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