Wheatland Internal Medicine Clinic | |
2701 Prince George Ave Ste 100 Desoto TX 75115-2087 | |
(972) 634-8110 | |
(972) 634-8220 |
Full Name | Wheatland Internal Medicine Clinic |
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Speciality | Internal Medicine |
Location | 2701 Prince George Ave Ste 100, Desoto, Texas |
Authorized Official Name and Position | Shehetaj Abdurrahim (MANAGING PHYSICIAN) |
Authorized Official Contact | 9726348110 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wheatland Internal Medicine Clinic 2701 Prince George Ave Ste 100 Desoto TX 75115-2087 Ph: (972) 555-5555 | Wheatland Internal Medicine Clinic 2701 Prince George Ave Ste 100 Desoto TX 75115-2087 Ph: (972) 634-8110 |
NPI Number | 1255197653 |
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Provider Enumeration Date | 02/23/2024 |
Last Update Date | 02/23/2024 |
Medicare PECOS PAC ID | 4082052600 |
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Medicare Enrollment ID | O20240402002194 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255197653 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Shehetaj Abdurrahim |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1437188372 PECOS PAC ID: 5395815914 Enrollment ID: I20080609000141 |
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