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NPI Code Detail

MEDICARE: ALICIA BREANN WHITEIS MD

MEDICARE: ALICIA BREANN WHITEIS MD
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
1208000000XPediatrics Physician2022-00915NC

General Provider Information

NPI Number : 1821651548
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA BREANN WHITEIS MD
Provider Business Mailing Address
First Line : PO BOX 110566
Second Line :
City : DURHAM
State : NC
Zip : 27709-5566
Country : US
Telephone Number : 919-620-4555
Fax Number :
Provider Business Practice Location Address
First Line : 2301 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4699
Country : US
Telephone Number : 919-668-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2019
Last Update Date : 05/05/2026

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