Provider Demographics
NPI:1003868902
Name:WHITING, MARK ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:WHITING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-0744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-266-4943
Practice Address - Street 1:400 PINELLAS ST
Practice Address - Street 2:SUITE 350
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3312
Practice Address - Country:US
Practice Address - Phone:727-462-3696
Practice Address - Fax:813-635-2637
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME40428207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110011884OtherRAILROAD MEDICARE
FL263528300Medicaid
FL62515ZMedicare PIN
FL110011884OtherRAILROAD MEDICARE