MEDICARE: CHANTE' WHITAKER PA-C

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	363AM0700X	Medical Physician Assistant	C0009217	MD
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1962100883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANTE' WHITAKER PA-C

Provider Business Mailing Address
First Line	:	11890 HEALING WAY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11890 HEALING WAY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7917
Country	:	US
Telephone Number	:	240-637-4000
Fax Number	:

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

Provider Enumeration Date	:	02/20/2023
Last Update Date	:	01/21/2026

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Directions to “ CHANTE' WHITAKER PA-C” Practice Location

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