Healthcare Provider Details

I. General information

NPI: 1225240765
Provider Name (Legal Business Name): MICHAEL A WHITMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S AKERS ST
VISALIA CA
93277-8311
US

IV. Provider business mailing address

123 SE 3RD AVE # 536
MIAMI FL
33131-2003
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-3300
  • Fax:
Mailing address:
  • Phone: 305-458-4730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberME64009
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG80016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: