Provider Demographics
NPI:1134363393
Name:WHITMAN, MEGAN HENNESSEY (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:HENNESSEY
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:1020 29TH STREET
Practice Address - Street 2:SUITE 480
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-733-3777
Practice Address - Fax:916-454-6780
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA253471207R00000X
WAMD60467422207R00000X
CAC149230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8930676Medicare UPIN