Individual
DR. MATTHEW G WHITIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1229 C AVE E, OSKALOOSA, IA 52577-4246
(641) 672-3100
(641) 672-3111
Mailing address
1229 C AVE E, OSKALOOSA, IA 52577-4246
(641) 672-3100
(641) 672-3111
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
26132
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037770
—
IA
01
—
10441
IA BC PROVIDER NUMBER
IA
01
—
P00147874
IA RR MEDICARE PROVIDER N
IA
Enumeration date
01/20/2006
Last updated
07/09/2007
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