1871614339 NPI number — DR. LANI SMITH MAJER WHEELER MD

Table of content: DR. LANI SMITH MAJER WHEELER MD (NPI 1871614339)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871614339 NPI number — DR. LANI SMITH MAJER WHEELER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHEELER
Provider First Name:
LANI
Provider Middle Name:
SMITH MAJER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAJER
Provider Other First Name:
LANI
Provider Other Middle Name:
SMITH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871614339
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
163 CRANES CROOK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-7267
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-573-1136
Provider Business Mailing Address Fax Number:
410-222-4067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 HARRY S TRUMAN PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-7031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-222-4133
Provider Business Practice Location Address Fax Number:
410-222-4067
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0006X , with the licence number:  AM8286610 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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