Provider Demographics
NPI:1659449320
Name:WHITESELL, DENA L (MD)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:L
Last Name:WHITESELL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:22 BRAMHALL ST
Mailing Address - Street 2:DEPT OF PSYCHIATRY, UNIT P6
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3134
Mailing Address - Country:US
Mailing Address - Phone:207-662-4463
Mailing Address - Fax:207-662-6377
Practice Address - Street 1:22 BRAMHALL ST
Practice Address - Street 2:DEPT OF PSYCHIATRY, UNIT P6
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3134
Practice Address - Country:US
Practice Address - Phone:207-662-4463
Practice Address - Fax:207-662-6377
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2009-12-18
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Provider Licenses
StateLicense IDTaxonomies
MEEC-05-0502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME001319601Medicare PIN