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NPI 1023810850

NPI 1023810850 : ELIZABETH HAYNES WHITAKER DO : CLEVELAND, OH

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General NPI Number Information
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    NPI Number           |    1023810850
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH HAYNES WHITAKER DO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/25/2025
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    Last Update Date     |    03/25/2025
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Provider Practice Location Address
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    Address Line         |    11100 EUCLID AVE 
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    City                 |    CLEVELAND
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    State                |    OH
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    Zip                  |    44106-1716
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    Country              |    US
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    Telephone            |    216-844-1000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    41 HARVEST WOODS RD 
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    City                 |    ROCKFALL
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    State                |    CT
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    Zip                  |    06481-2052
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    Country              |    US
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    Telephone            |    860-759-9005
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    Fax                  |    
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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