Individual
HOLLY WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10122 E 10TH ST, SUITE 100, INDIANAPOLIS, IN 46229-2663
(317) 355-5913
(317) 355-3760
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02004265A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11016162A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201068200
—
IN
01
—
P01512450
RR MEDICARE
IN
Enumeration date
06/30/2011
Last updated
06/09/2021
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