Individual
CHARLES T WHITTENBURG
Active
Individual
CHARLES T WHITTENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
L1779
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507816
—
TX
05
—
150781602
—
TX
05
—
150781603
—
TX
Enumeration date
07/17/2006
Last updated
10/09/2017
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