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Individual

DAVID W WHALEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 752-6751
Mailing address
PO BOX Q, GRAND RAPIDS, MI 49501-4917
(800) 968-6866

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301087452
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4873143
MI
01
DW087452
BLUE CROSS BLUE SHIELD
01
P00343931
RAILROAD MEDICARE
Enumeration date
06/12/2006
Last updated
03/04/2008
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