MEDICARE: DR. MICHAEL JAMES WHEELER PT, DPT, ATC

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	225100000X	Physical Therapist	22197	MD

General Provider Information

NPI Number	:	1730491358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JAMES WHEELER PT, DPT, ATC

Provider Business Mailing Address
First Line	:	PO BOX 67
Second Line	:
City	:	LISBON
State	:	MD
Zip	:	21765-0067
Country	:	US
Telephone Number	:	443-605-3464
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 DAISY RD
Second Line	:
City	:	WOODBINE
State	:	MD
Zip	:	21797-8128
Country	:	US
Telephone Number	:	443-605-3464
Fax Number	:

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

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	07/12/2010

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