Provider Demographics
NPI:1629416946
Name:WHALEN, CHRISTOPHER CURTIS (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CURTIS
Last Name:WHALEN
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 1:1501 HICKORY HILL DR
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-2187
Mailing Address - Country:US
Mailing Address - Phone:706-769-9033
Mailing Address - Fax:
Practice Address - Street 1:1501 HICKORY HILL DR
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-2187
Practice Address - Country:US
Practice Address - Phone:706-769-9033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.053040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine