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General NPI Number Information
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NPI Number | 1609366178
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Entity Type | Individual
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Provider Name | MEREDITH PAIGE WHITTAKER
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Gender | Female
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 4548 EMPIRE CT
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-1939
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Country | US
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Telephone | 540-373-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 N CAMPBELL AVE RM 4334D
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City | TUCSON
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State | AZ
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Zip | 85724-5058
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Country | US
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Telephone | 520-626-7747
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Fax | 520-626-2247
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R76726
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License Number State | AZ
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