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Individual

JOHN WHITED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
30200 TELEGRAPH RD, SUITE 220, BINGHAM FARMS, MI 48025-4502
(248) 258-5058
Mailing address
22101 MOROSS RD, DETROIT, MI 48236-2148

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4704204265
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704204265
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104796278
MI
Enumeration date
05/04/2006
Last updated
11/26/2019
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