Healthcare Provider Details

I. General information

NPI: 1497128169
Provider Name (Legal Business Name): STEVEN WHITMORE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2824 TRAFFORD RD
ROYAL OAK MI
48073-2909
US

IV. Provider business mailing address

2824 TRAFFORD RD
ROYAL OAK MI
48073-2909
US

V. Phone/Fax

Practice location:
  • Phone: 248-547-1841
  • Fax:
Mailing address:
  • Phone: 248-298-9921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801062646
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: