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NPI Code Detail

MEDICARE: DR. ELIZABETH G WHITAKER M.D.

MEDICARE:  DR. ELIZABETH G WHITAKER  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
1207Y00000XOtolaryngology Physician041239GA
22082S0099XPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician041239GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811999402
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH G WHITAKER M.D.
Provider Business Mailing Address
First Line : 3200 COBB GALLERIA PKWY STE 205
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5919
Country : US
Telephone Number : 770-850-0202
Fax Number :
Provider Business Practice Location Address
First Line : 3200 COBB GALLERIA PKWY STE 205
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5919
Country : US
Telephone Number : 770-850-0202
Fax Number : 770-850-0022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 04/11/2012

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