Provider Demographics
NPI:1780208272
Name:BUCK, WHITNEY NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:NICOLE
Last Name:BUCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:WHITNEY
Other - Middle Name:NICOLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:16001 W 9 MILE RD BLDG STE 401
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4818
Mailing Address - Country:US
Mailing Address - Phone:248-849-5664
Mailing Address - Fax:248-849-5324
Practice Address - Street 1:16001 W 9 MILE RD BLDG STE 401
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-5664
Practice Address - Fax:248-849-5324
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351046733207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology