Healthcare Provider Details

I. General information

NPI: 1912999228
Provider Name (Legal Business Name): LINDA WHITBY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3666 MUDDY CREEK RD
EDGEWATER MD
21037-3418
US

IV. Provider business mailing address

3666 MUDDY CREEK RD
EDGEWATER MD
21037-3418
US

V. Phone/Fax

Practice location:
  • Phone: 443-203-0103
  • Fax: 443-203-0104
Mailing address:
  • Phone: 443-203-0103
  • Fax: 443-203-0104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD17162
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD17162
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD17162
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberD17162
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: