Provider Demographics
NPI:1811137649
Name:WHYTE, CHARLES EVERS (MS, DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EVERS
Last Name:WHYTE
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 MYANO LN
Mailing Address - Street 2:SUITE 26
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4532
Mailing Address - Country:US
Mailing Address - Phone:203-708-9299
Mailing Address - Fax:203-708-9269
Practice Address - Street 1:30 MYANO LN
Practice Address - Street 2:SUITE 26
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4532
Practice Address - Country:US
Practice Address - Phone:203-708-9299
Practice Address - Fax:203-708-9269
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001341111NN1001X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No133N00000XDietary & Nutritional Service ProvidersNutritionist