Provider Demographics
NPI:1043246515
Name:WHIGHAM, MARTIN D (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:D
Last Name:WHIGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63436
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3436
Mailing Address - Country:US
Mailing Address - Phone:864-848-9555
Mailing Address - Fax:864-999-3713
Practice Address - Street 1:1 SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3955
Practice Address - Country:US
Practice Address - Phone:864-255-1000
Practice Address - Fax:864-269-1361
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14921207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC050029182OtherRR
SCG29970Medicaid
SCG29970Medicaid
SC050029182OtherRR
E88631Medicare UPIN