Provider Demographics
NPI:1326072729
Name:WHITWORTH, CLAUDE (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:
Last Name:WHITWORTH
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 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:181 DANIEL RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-7151
Practice Address - Country:US
Practice Address - Phone:828-286-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25104207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8987264Medicaid
NC110033966OtherRAILROAD MEDICARE
NC1326072729Medicaid
NC87264OtherNC BC/BS
NC1326072729Medicaid
NC8987264Medicaid
NC211512AMedicare PIN
NC211512CMedicare PIN