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General NPI Number Information
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NPI Number | 1154566396
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Entity Type | Individual
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Provider Name | SARAH PHELPS WHITTAKER D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 2221 FORD PARKWAY SUITE #350
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City | SAINT PAUL
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State | MN
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Zip | 55116-3837
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Country | US
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Telephone | 651-698-8879
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Fax | 651-698-7243
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Provider Business Mailing Address
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Address Line | 2270 FORD PKWY STE 104
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City | SAINT PAUL
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State | MN
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Zip | 55116-3412
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Country | US
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Telephone | 651-698-8879
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Fax | 651-698-7243
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 969-025
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 830
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License Number State | MN
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