Provider Demographics
NPI:1619970050
Name:WHITTLER, STEVEN G (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:G
Last Name:WHITTLER
Suffix:
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 1:350 W THOMAS RD
Mailing Address - Street 2:ATTN: SURGICAL SUITE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013
Mailing Address - Country:US
Mailing Address - Phone:602-406-3541
Mailing Address - Fax:602-406-7135
Practice Address - Street 1:350 W THOMAS RD
Practice Address - Street 2:ATTN: SURGICAL SUITE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-406-3541
Practice Address - Fax:602-406-7135
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2000-125207L00000X
AZ69007207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM961287OtherPRONET / AETNA
NMNM009C93OtherBLUE CROSS BLUE SHEILD
AZ509648-01Medicaid
CO89630874Medicaid
TX1643553Medicaid
NM67215Medicaid
NM57229Medicaid
NMG53696Medicare UPIN