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NPI Code Detail

MEDICARE: DR. DAVID H. WHITCOMB PH.D.

MEDICARE: DR. DAVID H. WHITCOMB PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist399ND
2103TC0700XClinical Psychologist399ND

General Provider Information

NPI Number : 1316140346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID H. WHITCOMB PH.D.
Provider Business Mailing Address
First Line : 504 S 4TH ST
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-4712
Country : US
Telephone Number : 701-610-8000
Fax Number : 701-777-3184
Provider Business Practice Location Address
First Line : 217A S 4TH ST STE 202
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-4737
Country : US
Telephone Number : 701-772-1588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2007
Last Update Date : 10/19/2022

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