Provider Demographics
NPI:1982628111
Name:WHITNEY, CHARLES W (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4923 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2081
Mailing Address - Country:US
Mailing Address - Phone:302-683-0600
Mailing Address - Fax:302-683-0277
Practice Address - Street 1:4923 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 110
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2081
Practice Address - Country:US
Practice Address - Phone:302-683-0600
Practice Address - Fax:302-683-0277
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10002759207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000021701Medicaid
D01175Medicare UPIN
DE0000021701Medicaid