Individual
DR. DAVID GLENN WHALEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 BROAD ST, SUITE 100, SUMTER, SC 29150-4152
(803) 773-5227
(803) 418-0202
Mailing address
325 BROAD ST, SUITE 100, SUMTER, SC 29150-4167
(803) 773-5227
(803) 418-0202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19754
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080193764
MEDICARE RR PIN
SC
05
—
197548
—
SC
Enumeration date
08/24/2006
Last updated
03/10/2010
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