Organization · NPI-2

Albert Whitaker,jr. MD,pa

Clinic/Center · Gastonia, NC

NPI number1396003646
StatusActive
Last updated in NPPESApr 24, 2012

Details

NPI
1396003646
Entity type
Organization (NPI-2)
Legal business name
Albert Whitaker,jr. MD,pa
Organization subpart
No
Enumeration date
Apr 24, 2012
Last updated
Apr 24, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center23244NCYes

Practice location

224 S New Hope Rd
Suite K
Gastonia, NC 28054-4873

Phone 704-867-7494 · Fax 704-867-7432

Mailing address

224 S New Hope Rd
Suite K
Gastonia, NC 28054-4873

Phone 704-867-7494 · Fax 704-867-7432

Authorized official

Jeannette Whitaker
Business Administrator
7048677494

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