Provider Demographics
NPI:1467489815
Name:WHITELAW, GEORGE PERCY JR (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:PERCY
Last Name:WHITELAW
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:100 HIGHLAND ST
Mailing Address - Street 2:SUITE G1
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3874
Mailing Address - Country:US
Mailing Address - Phone:617-696-2300
Mailing Address - Fax:617-698-7542
Practice Address - Street 1:100 HIGHLAND ST
Practice Address - Street 2:SUITE G1
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3874
Practice Address - Country:US
Practice Address - Phone:617-696-2300
Practice Address - Fax:617-698-7542
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA34608207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2010593Medicaid
MA2010593Medicaid
MAB97245Medicare UPIN