Provider Demographics
NPI:1841379302
Name:WHITFIELD, HOWARD GREGORY
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:GREGORY
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4588 HUNTER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:NC
Mailing Address - Zip Code:28551-6743
Mailing Address - Country:US
Mailing Address - Phone:252-229-6186
Mailing Address - Fax:252-527-6186
Practice Address - Street 1:1318 WAYNE MEMORIAL DR STE A
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2255
Practice Address - Country:US
Practice Address - Phone:252-229-6186
Practice Address - Fax:252-527-6186
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1521225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist