Provider Demographics
NPI:1457354730
Name:WHITMORE, CRAIG E (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:E
Last Name:WHITMORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:30100 TELEGRAPH RD
Mailing Address - Street 2:STE 177
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025
Mailing Address - Country:US
Mailing Address - Phone:248-647-1470
Mailing Address - Fax:248-647-1472
Practice Address - Street 1:30100 TELEGRAPH RD
Practice Address - Street 2:STE 177
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025
Practice Address - Country:US
Practice Address - Phone:248-647-1470
Practice Address - Fax:248-647-1472
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2014-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301076235208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI250F004790OtherBLUE CROSS
MI250F004790OtherBLUE CROSS
MI0P35930Medicare PIN