Healthcare Provider Details
I. General information
NPI: 1386267318
Provider Name (Legal Business Name): WHITNEY CLARE CUMMINGS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/26/2020
Last Update Date: 08/07/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 LEONARD ST NE
GRAND RAPIDS MI
49505-5515
US
IV. Provider business mailing address
1400 LEONARD ST NE
GRAND RAPIDS MI
49505-5515
US
V. Phone/Fax
- Phone: 616-217-4435
- Fax:
- Phone: 616-217-4435
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 5101028034 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 5101028034 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: