1447304225 NPI number — DR. TODD ALLAN WHITTEMORE D.C.

Table of content: DR. TODD ALLAN WHITTEMORE D.C. (NPI 1447304225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447304225 NPI number — DR. TODD ALLAN WHITTEMORE D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITTEMORE
Provider First Name:
TODD
Provider Middle Name:
ALLAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1447304225
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
118 GREAT RD STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STOW
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01775-1190
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-897-1770
Provider Business Mailing Address Fax Number:
978-897-1715

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
118 GREAT RD
Provider Second Line Business Practice Location Address:
SUITE 215
Provider Business Practice Location Address City Name:
STOW
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01775-1190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-897-1770
Provider Business Practice Location Address Fax Number:
978-897-1715
Provider Enumeration Date:
01/22/2007

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: 111N00000X , with the licence number:  2723 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 655790 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 835626 . This is a "MPN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y36958 . This is a "BCBS MA INDIVIDUAL" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1368343002 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y39725 . This is a "BCBS MA GROUP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3236217 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 499711 . This is a "TUFTS HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 352540 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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