Provider Demographics
NPI:1033389267
Name:DAVID C WHITNEY SR DPM PC
Entity Type:Organization
Organization Name:DAVID C WHITNEY SR DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:DPM
Authorized Official - Phone:508-540-9112
Mailing Address - Street 1:95C DAVIS STRAITS
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-3909
Mailing Address - Country:US
Mailing Address - Phone:508-540-9112
Mailing Address - Fax:508-540-9114
Practice Address - Street 1:95C DAVIS STRAITS
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-3909
Practice Address - Country:US
Practice Address - Phone:508-540-9112
Practice Address - Fax:508-540-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1834213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY77155Medicare PIN