Individual
MATTHEW DEAN WHEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6511 COYLE AVE, CARMICHAEL, CA 95608-0306
(916) 863-8700
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A130592
CA
2085R0203X
Therapeutic Radiology Physician
A130592
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2009
Last updated
07/10/2014
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