Provider Demographics
NPI:1134240930
Name:WHITFIELD, MILTON LOUIS JR (RTPO)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:LOUIS
Last Name:WHITFIELD
Suffix:JR
Gender:M
Credentials:RTPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MORREENE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2912
Mailing Address - Country:US
Mailing Address - Phone:919-471-4994
Mailing Address - Fax:919-471-4995
Practice Address - Street 1:400 CRUTCHFIELD ST STE A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2771
Practice Address - Country:US
Practice Address - Phone:919-471-4994
Practice Address - Fax:919-471-4995
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4215300001Medicare ID - Type Unspecified