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General NPI Number Information
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NPI Number | 1962403766
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Entity Type | Individual
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Provider Name | DAVID C WHITEHEAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 232 MEMORIAL DRIVE
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City | JESUP
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State | GA
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Zip | 31545
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Country | US
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Telephone | 912-559-2337
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 71291
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City | PHILADELPHIA
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State | PA
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Zip | 19176-1291
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Country | US
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Telephone |
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 050852
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License Number State | GA
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