Individual
MRS. DEIDRA L WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPA-C
Contact information
Practice address
1918 RANDOLPH RD, SUITE 700, CHARLOTTE, NC 28207-1100
(704) 342-3544
(704) 370-6652
Mailing address
1918 RANDOLPH RD, SUITE 700, CHARLOTTE, NC 28207-1100
(704) 348-3544
(704) 370-6652
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/16/2007
Last updated
07/16/2013
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