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Individual
WILLIE R. WHITAKER
Active
Individual
WILLIE R. WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
NC2003-00428
NC
207RN0300X
Nephrology Physician
Primary
2003-00428
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134J6
BLUE CROSS BLUE SHIELD #
NC
01
—
3324386
CIGNA HEALTHCARE PROVIDER
NC
01
—
38354
PARTNERS' MEDICARE #
NC
05
—
89134J6
—
NC
01
—
C8620
MEDCOST
NC
01
—
E73961
UPIN
—
01
—
P00010140
RAILROAD MEDICARE
NC
Enumeration date
10/05/2005
Last updated
09/15/2026
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