Individual
DEREK WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1621 PROVIDENCE RD S STE 370, WAXHAW, NC 28173-8331
(704) 520-7089
(704) 520-7099
Mailing address
4705 UNIVERSITY DR BLDG 700, DURHAM, NC 27707-3489
(919) 237-1337
(919) 237-1625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
0010-13935
NC
Other
Enumeration date
07/20/2020
Last updated
12/05/2024
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