Provider Demographics
NPI:1982049425
Name:WHIFFIN, AMY NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:NICOLE
Last Name:WHIFFIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 BROAD ROCK BLVD. EMERGENCY DEPARTMENT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:804-828-4603
Practice Address - Street 1:1201 BROAD ROCK BLVD. EMERGENCY DEPARTMENT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:804-828-4603
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101259334207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine