Healthcare Provider Details

I. General information

NPI: 1982628111
Provider Name (Legal Business Name): CHARLES W WHITNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4923 OGLETOWN STANTON RD SUITE 110
NEWARK DE
19713-2081
US

IV. Provider business mailing address

4923 OGLETOWN STANTON RD SUITE 110
NEWARK DE
19713-2081
US

V. Phone/Fax

Practice location:
  • Phone: 302-683-0600
  • Fax: 302-683-0277
Mailing address:
  • Phone: 302-683-0600
  • Fax: 302-683-0277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberC10002759
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: