Individual
DANIEL BENNETT WHITESIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 SUNNYBROOK RD STE 159, RALEIGH, NC 27610-1827
(984) 974-4832
(984) 974-4920
Mailing address
632 BROADWAY PH 12, NEW YORK, NY 10012-2614
(347) 294-3414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2022-03191
NC
207Q00000X
Family Medicine Physician
A139934
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2014
Last updated
03/20/2023
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