MEDICARE: CATHLEEN ANN WHELAN 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
1	207R00000X	Internal Medicine Physician	MD 10375	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	110217181	OTHER	RI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04-03194	OTHER	RI	UNITED HEALTH CARE
2	3820	OTHER	RI	NEIGHBORHOOD HEALTH
3	406988	OTHER	RI	BCHIP
4	697702	OTHER	RI	HARVARD PILGRIM HEALTH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	103750	OTHER	RI	TUFTS HEALTH PLAN
7	0000022110	OTHER	RI	B/C

General Provider Information

NPI Number	:	1992706600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHLEEN ANN WHELAN MD

Provider Business Mailing Address
First Line	:	110 ELM ST FL 3
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-4626
Country	:	US
Telephone Number	:	401-443-4992
Fax Number	:	401-537-7241

Provider Business Practice Location Address
First Line	:	164 SUMMIT AVE
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02906-2853
Country	:	US
Telephone Number	:	401-649-4050
Fax Number	:	401-649-4051

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	09/27/2021

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