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NPI Code Detail

MEDICARE: DR. STEVEN DALE WHALEY M.D.

MEDICARE: DR. STEVEN DALE WHALEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083P0500XPreventive Medicine/Occupational Environmental Medicine Physician01034756IN

General Provider Information

NPI Number : 1205971165
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN DALE WHALEY M.D.
Provider Business Mailing Address
First Line : 51033 HUNTINGTON LN
Second Line :
City : GRANGER
State : IN
Zip : 46530-8813
Country : US
Telephone Number : 574-271-0436
Fax Number :
Provider Business Practice Location Address
First Line : 4111 FRANKLIN ST
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-7803
Country : US
Telephone Number : 219-476-9389
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/09/2007

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