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General NPI Number Information
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NPI Number | 1659358547
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Entity Type | Individual
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Provider Name | DENNIS C WHITEHEAD MD
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 1721 S STEPHENSON AVE
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-3637
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Country | US
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Telephone | 906-774-1313
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Fax | 906-774-5639
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Provider Business Mailing Address
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Address Line | PO BOX 549
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-0549
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Country | US
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Telephone | 906-774-1313
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Fax | 906-774-5639
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301038973
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License Number State | MI
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