Provider Demographics
NPI:1861588436
Name:WHEELER, DAWN ELAINE (MD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ELAINE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE ST SE MMC 292
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-884-0999
Mailing Address - Fax:
Practice Address - Street 1:2001 BLOOMINGTON AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3074
Practice Address - Country:US
Practice Address - Phone:612-301-3433
Practice Address - Fax:612-627-4205
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28030207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN267877200Medicaid
MN108447OtherUCARE
MN71R92WHOtherBLUE CROSS BLUE SHIELD
MN842085OtherARAZ
MN04-08524OtherMEDICA - CHOICE
MN1007701OtherPREFERREDONE
MN04-08524OtherMEDICA - PRIMARY
MN162081OtherFAIRVIEW
MNHP14678OtherHEALTHPARTNERS
MN04-08524OtherMEDICA - CHOICE