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NPI Code Detail

MEDICARE: BRANDON HAROLD WHITEHOUSE PRSS

MEDICARE: BRANDON HAROLD WHITEHOUSE PRSS
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
1175T00000XPeer Specialist18-918WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316680549
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON HAROLD WHITEHOUSE PRSS
Provider Business Mailing Address
First Line : 200 12TH STREET EXT
Second Line :
City : PRINCETON
State : WV
Zip : 24740-2329
Country : US
Telephone Number : 304-818-2222
Fax Number :
Provider Business Practice Location Address
First Line : 1345 MERCER ST
Second Line :
City : PRINCETON
State : WV
Zip : 24740-3033
Country : US
Telephone Number : 304-818-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2022
Last Update Date : 04/15/2022

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Directions to “ BRANDON HAROLD WHITEHOUSE PRSS” Practice Location

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