MEDICARE: DR. MICHAEL R WHETSTONE M.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
1	174400000X	Specialist	G5764	TX

General Provider Information

NPI Number	:	1689637076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL R WHETSTONE M.D.

Provider Business Mailing Address
First Line	:	7433 LAS COLINAS BLVD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7575
Country	:	US
Telephone Number	:	972-831-8822
Fax Number	:	972-831-8858

Provider Business Practice Location Address
First Line	:	7433 LAS COLINAS BLVD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7575
Country	:	US
Telephone Number	:	972-831-8822
Fax Number	:	972-831-8858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	07/21/2008

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