Provider Demographics
NPI:1881413029
Name:WHITMAN, MARK DECATUR
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:DECATUR
Last Name:WHITMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 FALMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-2665
Mailing Address - Country:US
Mailing Address - Phone:508-648-9523
Mailing Address - Fax:
Practice Address - Street 1:299 FALMOUTH RD
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2665
Practice Address - Country:US
Practice Address - Phone:508-648-9523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker