Individual
DAVID H WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 2500, SPARTANBURG, SC 29303-4201
(864) 585-5433
(864) 591-4053
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
19241
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19241
SC LICENSE
SC
01
—
SC56206067
MEDICARE PIN
SC
01
—
SC56206121
MEDICARE PIN
SC
01
—
SC5620J577
MEDICARE PIN
SC
Enumeration date
01/20/2015
Last updated
01/14/2021
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