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General NPI Number Information
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NPI Number | 1609688779
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Entity Type | Organization
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Legal Business Name | WHITTINGTON DERMATOLOGY LLC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 800 MACARTHUR BLVD STE 6
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City | MUNSTER
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State | IN
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Zip | 46321-2917
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Country | US
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Telephone | 219-398-4234
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Fax |
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Provider Business Mailing Address
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Address Line | 800 MACARTHUR BLVD STE 6
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City | MUNSTER
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State | IN
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Zip | 46321-2917
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Country | US
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Telephone | 219-398-4234
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ADAM WHITTINGTON
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Credential | MD
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Telephone | 219-398-4234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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