=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588974265
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DARIUS ANTONIO WHITAKER SR. M.S. P.A.-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2010
-----------------------------------------------------
Last Update Date | 10/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 HIGHLAND AVE
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-988-0000
-----------------------------------------------------
Fax | 717-782-5716
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 409 S 2ND ST STE 2F
-----------------------------------------------------
City | HARRISBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17104-1612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-988-0000
-----------------------------------------------------
Fax | 717-782-5716
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | MA057541
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | C0004364
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------