Provider Demographics
NPI:1366656076
Name:JAMES E WHITMAN MD PC,
Entity Type:Organization
Organization Name:JAMES E WHITMAN MD PC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-368-5330
Mailing Address - Street 1:3930 E 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1012
Mailing Address - Country:US
Mailing Address - Phone:313-368-5330
Mailing Address - Fax:313-368-6819
Practice Address - Street 1:3930 E 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1012
Practice Address - Country:US
Practice Address - Phone:313-368-5330
Practice Address - Fax:313-368-6819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301022757208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0829356OtherBCBSM PIN NUMBER
MIBW1314498OtherFEDERAL DEA
MIB46194Medicare UPIN
MI0829356Medicare ID - Type Unspecified