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Individual

MR. ALBERT WHITAKER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
224 S NEW HOPE RD, SUITE K, GASTONIA, NC 28054-4873
(704) 867-7494
(704) 867-7432
Mailing address
224 SOUTH NEW HOPE RD., SUITE K, GASTONIA, NC 28054-0020
(704) 867-7494
(704) 867-7432

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
23244
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86901
BCBSNC
NC
05
8986901
NC
Enumeration date
01/17/2007
Last updated
02/22/2010
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