MEDICARE: DR. DAVID STAFFORD WHITNEY 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	207X00000X	Orthopaedic Surgery Physician	MD00010506	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	601-432692	OTHER		WA STATE UBI
2	44034	OTHER	WA	WA STATE LABOR AND INDUSTRIES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851548010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID STAFFORD WHITNEY M.D.

Provider Business Mailing Address
First Line	:	1045 QUINCY ST
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-5414
Country	:	US
Telephone Number	:	360-385-6190
Fax Number	:

Provider Business Practice Location Address
First Line	:	1045 QUINCY ST
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-5414
Country	:	US
Telephone Number	:	360-385-6190
Fax Number	:

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

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	08/19/2008

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