MEDICARE: MS. TAMARA MARIE WHITAKER BAY DPM

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
1	213E00000X	Podiatrist	TW002034	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	7287715	OTHER	AETNA
2	2730125	OTHER	UHC IBA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	480C912300	OTHER	BCBSM
5	522456150	OTHER	TRICARE

General Provider Information

NPI Number	:	1912976978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMARA MARIE WHITAKER BAY DPM

Provider Business Mailing Address
First Line	:	515 HOWARD STREET
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49008-1917
Country	:	US
Telephone Number	:	269-385-1000
Fax Number	:	269-385-5120

Provider Business Practice Location Address
First Line	:	515 HOWARD STREET
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49008-1917
Country	:	US
Telephone Number	:	269-385-1000
Fax Number	:	269-385-5120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	09/09/2008

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