1699871368 NPI number — DR. GAYLE ANN WHITMER MD

Table of content: DR. GAYLE ANN WHITMER MD (NPI 1699871368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699871368 NPI number — DR. GAYLE ANN WHITMER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITMER
Provider First Name:
GAYLE
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1699871368
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
90 RITCHIE HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21122-4303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-837-1521
Provider Business Mailing Address Fax Number:
410-544-5449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 RITCHIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21122-4303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-837-1521
Provider Business Practice Location Address Fax Number:
410-544-5449
Provider Enumeration Date:
09/16/2006

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: 207Q00000X , with the licence number:  25111 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0002X , with the licence number: MD25111 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0002X , with the licence number: D84226 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 13847 . This is a "NEVADA MEDICAL LICENSE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 807577600 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: MD25111 . This is a "OREGON MEDICAL LICENSE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: D84226 . This is a "MD LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: M-9961 . This is a "IDAHO MEDICAL LICENSE" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com