Provider Demographics
NPI:1407159387
Name:WHITEHURST, LEE A (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:A
Last Name:WHITEHURST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 LANDFALL DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-4251
Mailing Address - Country:US
Mailing Address - Phone:910-256-6391
Mailing Address - Fax:910-256-6391
Practice Address - Street 1:1401 LANDFALL DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-4251
Practice Address - Country:US
Practice Address - Phone:910-256-6391
Practice Address - Fax:910-256-6391
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18070207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine