Healthcare Provider Details

I. General information

NPI: 1538151584
Provider Name (Legal Business Name): JAMES H WHITMYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36015 UTICA RD
CLINTON TOWNSHIP MI
48035-1021
US

IV. Provider business mailing address

18303 E 10 MILE RD STE 500
ROSEVILLE MI
48066-4992
US

V. Phone/Fax

Practice location:
  • Phone: 586-741-4650
  • Fax: 586-741-4655
Mailing address:
  • Phone: 586-498-5160
  • Fax: 586-498-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301070292
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: