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NPI Code Detail

MEDICARE: DR. KEVIN D. WHALEY MD

MEDICARE: DR. KEVIN D. WHALEY MD
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
1207ZF0201XForensic Pathology Physician17603ND
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1598429433
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN D. WHALEY MD
Provider Business Mailing Address
First Line : 738 VINEYARD CIR
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-2920
Country : US
Telephone Number : 585-709-6465
Fax Number :
Provider Business Practice Location Address
First Line : 305 ROBERTS ST N
Second Line :
City : FARGO
State : ND
Zip : 58102-4716
Country : US
Telephone Number : 701-404-9180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2021
Last Update Date : 07/10/2025

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