Glenn S. Wheet, Md, Pc | |
900 Lincoln Way W Mishawaka IN 46544-1716 | |
(574) 259-6937 | |
(574) 259-6939 |
Full Name | Glenn S. Wheet, Md, Pc |
---|---|
Speciality | Family Medicine |
Location | 900 Lincoln Way W, Mishawaka, Indiana |
Authorized Official Name and Position | Glenn Scott Wheet (PRESIDENT) |
Authorized Official Contact | 5742596937 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Glenn S. Wheet, Md, Pc 900 Lincoln Way W Mishawaka IN 46544-1716 Ph: (574) 259-6937 | Glenn S. Wheet, Md, Pc 900 Lincoln Way W Mishawaka IN 46544-1716 Ph: (574) 259-6937 |
NPI Number | 1316065444 |
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Provider Enumeration Date | 03/27/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 5092779272 |
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Medicare Enrollment ID | O20041117000472 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316065444 | NPI | - | NPPES |
000000350460 | Other | IN | ANTHEM BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 01048975A (Indiana) | Primary |
Provider Name | Glenn Scott Wheet |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588700876 PECOS PAC ID: 7517921794 Enrollment ID: I20041122001026 |
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