| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5092779272 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588700876 PECOS PAC ID: 7517921794 Enrollment ID: I20041122001026 |
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