Individual
THOMAS L WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ONE MEMORIAL SQ, STE 50, GREENFIELD, IN 46140-1357
(317) 467-7100
(317) 467-0209
Mailing address
6330 E 75TH ST, INDIANAPOLIS, IN 46250-2777
(317) 594-6900
(317) 594-6911
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
01041624
IN
207RX0202X
Medical Oncology Physician
Primary
01041624
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100323710
—
IN
01
—
900000282
RAILROAD MEDICARE PIN
IN
01
—
P01055080
RAILROAD MEDICARE PIN
IN
Enumeration date
08/16/2005
Last updated
08/10/2012
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