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General NPI Number Information
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NPI Number | 1205992203
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Entity Type | Organization
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Legal Business Name | ROBERT N WHITAKER JR MD PA
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 330 JAKE ALEXANDER BLVD WEST SUITE 101
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City | SALISBURY
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State | NC
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Zip | 28147
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Country | US
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Telephone | 704-637-5668
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Fax | 704-637-5605
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Provider Business Mailing Address
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Address Line | PO BOX 5116 330 JAKE ALEXANDER BLVD WEST SUITE 101
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City | SALISBURY
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State | NC
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Zip | 28147
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Country | US
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Telephone | 704-637-5668
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Fax | 704-637-5605
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT N WHITAKER JR.
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Credential | MD
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Telephone | 704-637-5668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | 9500766
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License Number State | NC
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