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DR. STEPHAN HARRIS WHITENACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5401 OLD YORK RD, KLEIN 101, PHILADELPHIA, PA 19141-3030
(215) 456-6178
(215) 456-6204
Mailing address
PO BOX 8500-8735, PHILADELPHIA, PA 19178-8735
(215) 456-7000
(215) 254-2599

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD016782E
PA
2086S0129X
Vascular Surgery Physician
Primary
MD016782E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0006557540001
PA
Enumeration date
05/03/2006
Last updated
01/16/2013
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