Provider Demographics
NPI:1346248861
Name:WHITMAN, MONROE CALVIN III (MD)
Entity Type:Individual
Prefix:
First Name:MONROE
Middle Name:CALVIN
Last Name:WHITMAN
Suffix:III
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 1:875 WESLEY ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1613
Mailing Address - Country:US
Mailing Address - Phone:360-435-6097
Mailing Address - Fax:360-435-1871
Practice Address - Street 1:875 WESLEY ST
Practice Address - Street 2:SUITE 230
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1613
Practice Address - Country:US
Practice Address - Phone:360-435-6097
Practice Address - Fax:360-435-1871
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026616174400000X
ND19326208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8202640Medicaid
WA8202640Medicaid
WAD08030Medicare UPIN