Provider Demographics
NPI:1528232998
Name:WHITMER, DOROTA ANNA (MD)
Entity Type:Individual
Prefix:
First Name:DOROTA
Middle Name:ANNA
Last Name:WHITMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14601 DETROIT AVE
Mailing Address - Street 2:#540
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4214
Mailing Address - Country:US
Mailing Address - Phone:216-529-5300
Mailing Address - Fax:
Practice Address - Street 1:14601 DETROIT AVE
Practice Address - Street 2:#540
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4214
Practice Address - Country:US
Practice Address - Phone:216-529-5300
Practice Address - Fax:216-529-5301
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0072285207RE0101X
OH124545207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism