MEDICARE: STAGGERS HEARE & WHITEMAN PA

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CM4138	OTHER		RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	116441251494	OTHER		HUMANA INSURANCE CO
3	R950	OTHER		CAREFIRST BCBS OF DC NCA
4	S986	OTHER	MD	BLUE CROSS BLUE SHIELD
5	1017320	OTHER	WV	WORKERS COMPENSATION
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	11015	OTHER	MD	WORKERS COMPENSATION
8	5766011	OTHER		AETNA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	222830	OTHER	MD	MAMSI

NPI Number	:	1336193887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAGGERS HEARE & WHITEMAN PA

Provider Business Mailing Address
First Line	:	11801 UPPER POTOMAC INDSTRL PARK ST SW
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-5139
Country	:	US
Telephone Number	:	301-729-3485
Fax Number	:	301-729-0158

Provider Business Practice Location Address
First Line	:	11801 UPPER POTOMAC INDSTRL PARK ST SW
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-5139
Country	:	US
Telephone Number	:	301-729-3485
Fax Number	:	301-729-0158

Authorized Official
Title or Position	:	PRESIDENT/OFFICER
Name	:	MR. ROY DAVID RUSSELL WHITEMAN, JR. JR.
Credential	:	PT, MBA
Telephone Number	:	301-729-3485

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	02/11/2022