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Individual

DR. LEE CARL WHITAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1901 9TH STREET, ST THOMAS, VI 00802-0000
(340) 777-1996
Mailing address
PO BOX 7425, ST THOMAS, VI 00801-0425
(340) 777-1996

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD000035229
TN
207QA0505X
Adult Medicine Physician
Primary
1625
VI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009911897
AL
01
1508809625
NPI
TN
Enumeration date
06/14/2006
Last updated
05/09/2012
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