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Individual

DR. DEREK CASPER WHITAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101102607
VA
207X00000X
Orthopaedic Surgery Physician
Primary
67468
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
67468
GEORGIA MEDICAL LICENSE
GA
Enumeration date
02/23/2006
Last updated
01/02/2020
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