1346248861 NPI number — MONROE CALVIN WHITMAN III M.D.

Table of content: MONROE CALVIN WHITMAN III M.D. (NPI 1346248861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346248861 NPI number — MONROE CALVIN WHITMAN III M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITMAN
Provider First Name:
MONROE
Provider Middle Name:
CALVIN
Provider Name Prefix Text:
Provider Name Suffix Text:
III
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346248861
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
875 WESLEY ST
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98223-1613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-435-6097
Provider Business Mailing Address Fax Number:
360-435-1871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
875 WESLEY ST
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98223-1613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-435-6097
Provider Business Practice Location Address Fax Number:
360-435-1871
Provider Enumeration Date:
07/08/2005

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: 174400000X , with the licence number:  MD00026616 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 19326 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8202640 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com