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Organization

UNIVERSITY PEDIATRICS DBA CHILDREN'S MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES M WHEELER III PPCNP-BC (PEDIATRIC NURSE PRACTIONER)
(401) 633-1100
Entity
Organization

Contact information

Practice address
100 HIGHLAND AVE, SUITE 201, PROVIDENCE, RI 02906-2740
(401) 633-1100
(401) 633-0047
Mailing address
100 HIGHLAND AVE, SUITE 201, PROVIDENCE, RI 02906-2740
(401) 633-1100
(401) 633-0047

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN00401
RI

Other

Enumeration date
04/08/2015
Last updated
04/08/2015
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