Individual
DR. STANLEY WAYNE WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 PLEASANT ST, CONWAY, NH 03818
(603) 447-3313
(603) 447-4310
Mailing address
PO BOX 2048, CONWAY, NH 03818-2048
(603) 447-3313
(603) 447-4310
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
8788
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200597587
TIMBERLINE TAX ID
—
01
—
593763829
SOUND MED IMAGING TAX ID
—
Enumeration date
07/14/2005
Last updated
05/12/2009
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