Provider Demographics
NPI:1114024437
Name:WHITNEY, CHARLES CANDEE III (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CANDEE
Last Name:WHITNEY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1121 GENERAL WASHINGTON MEMORIAL BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977
Mailing Address - Country:US
Mailing Address - Phone:215-321-1371
Mailing Address - Fax:215-321-1378
Practice Address - Street 1:1121 GENERAL WASHINGTON MEMORIAL BOULEVARD
Practice Address - Street 2:
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977
Practice Address - Country:US
Practice Address - Phone:215-321-1371
Practice Address - Fax:215-321-1378
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD048097L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G21828Medicare UPIN