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General NPI Number Information
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NPI Number | 1023452562
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Entity Type | Individual
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Provider Name | MARY WHITTEMORE M.D., M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2013
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 540 BELVEDERE BLVD STE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-3215
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Country | US
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Telephone | 434-654-2830
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Fax | 833-232-3632
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Provider Business Mailing Address
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Address Line | PO BOX 79777
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City | BALTIMORE
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State | MD
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Zip | 21279-0777
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Country | US
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Telephone | 434-654-7794
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Fax | 833-732-3632
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101260888
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License Number State | VA
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