Provider Demographics
NPI:1770566465
Name:WHITTED, THURMAN B JR (MD)
Entity type:Individual
Prefix:DR
First Name:THURMAN
Middle Name:B
Last Name:WHITTED
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:252-744-3253
Mailing Address - Fax:252-744-3194
Practice Address - Street 1:604 MEDICAL DR
Practice Address - Street 2:ECU PHYSICIANS PHYSICAL MEDICINE & REHABILITATION
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7503
Practice Address - Country:US
Practice Address - Phone:252-847-6600
Practice Address - Fax:252-847-2204
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2011-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9601525208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10910OtherBCBS NC
NCP00030684OtherRAILROAD MEDICARE
NC8910910Medicaid
NC2245292BMedicare PIN
NC10910OtherBCBS NC