Individual
BRENT E. WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4545 CORDATA PKWY, BELLINGHAM, WA 98226-7123
(360) 738-2200
(360) 752-5686
Mailing address
PO BOX 5096, BELLINGHAM, WA 98227-5096
(360) 738-2200
(360) 752-5686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
89965
CA
207Q00000X
Family Medicine Physician
Primary
MD00046649
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0229987
L&I AND CRIME VICTIMS
WA
05
—
1528012028
—
WA
01
—
2854WH
REGENCE
WA
01
—
7097802
AETNA
WA
05
—
8457681
—
WA
01
—
P00607300
RAILROAD MEDICARE
WA
Enumeration date
05/19/2006
Last updated
10/19/2023
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