Individual
DR. MARY CANDACE WHITEHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
930 W 21ST ST, SUITE 100, NORFOLK, VA 23517-1516
(757) 622-8358
(757) 622-7171
Mailing address
7007 HARBOUR VIEW BLVD, SUITE 108, SUFFOLK, VA 23435-3657
(757) 215-2784
(757) 215-2728
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101041536
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011268
CIGNA HEALTH PLAN
VA
01
—
1100181707
RAILROAD MEDICARE
VA
01
—
13900
OPTIMA HEALTH PLAN
VA
01
—
325493
ANTHEM BLUE CROSS BLUE SH
VA
05
—
5824826
—
VA
Enumeration date
08/05/2006
Last updated
05/25/2016
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