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General NPI Number Information
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NPI Number | 1275513715
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Entity Type | Individual
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Provider Name | DAVID ROBERT WHITTAKER MD
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-4779
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 64323
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City | BALTIMORE
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State | MD
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Zip | 21264-4323
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Country | US
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Telephone | 443-481-6549
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Fax | 443-481-6515
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0101232175
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | D0064058
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License Number State | MD
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