Healthcare Provider Details

I. General information

NPI: 1346214822
Provider Name (Legal Business Name): PAUL E. WHALEN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 HEALTH CAMPUS DR
ROCKINGHAM VA
22801-8679
US

IV. Provider business mailing address

PO BOX 1430
HARRISONBURG VA
22803-1430
US

V. Phone/Fax

Practice location:
  • Phone: 540-689-1110
  • Fax: 540-689-1119
Mailing address:
  • Phone: 540-689-1110
  • Fax: 540-689-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01057493A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101255229
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: