Provider Demographics
NPI:1750321089
Name:WHITTUM, JAMES REAM (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:REAM
Last Name:WHITTUM
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 1:620 NW 11TH ST STE M201
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-6941
Mailing Address - Country:US
Mailing Address - Phone:541-289-4118
Mailing Address - Fax:541-667-3484
Practice Address - Street 1:620 NW 11TH ST STE M201
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-6941
Practice Address - Country:US
Practice Address - Phone:541-289-7075
Practice Address - Fax:541-289-4116
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79616207X00000X
ORMD194739207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1455Medicaid
MA3127401Medicaid
MAJ14564Medicare ID - Type Unspecified
MAF80698Medicare UPIN