Individual
DR. DOUGLAS M WHITTEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
345 HANKS HILL RD, STORRS MANSFIELD, CT 06268-2349
(860) 420-9299
Mailing address
345 HANKS HILL RD, STORRS MANSFIELD, CT 06268-2349
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
023672
CT
174400000X
Specialist
238240
MA
208800000X
Urology Physician
Primary
238240
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9771476
—
MA
01
—
M20928
GROUP MEDICARE
MA
Enumeration date
05/16/2006
Last updated
01/24/2011
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