Healthcare Provider Details

I. General information

NPI: 1104152008
Provider Name (Legal Business Name): JAMES ROBERT WHITMER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 LAKE SHORE DR
WASHOE VALLEY NV
89704-9151
US

IV. Provider business mailing address

PO BOX 18266
RENO NV
89511-0266
US

V. Phone/Fax

Practice location:
  • Phone: 866-964-3795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number10054
License Number StateNV

VIII. Authorized Official

Name: DR. JAMES R WHITMER
Title or Position: OWNER
Credential: MD
Phone: 775-219-6434