Individual
JOHN RAYMOND WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27209 LAHSER RD, STE 224, SOUTHFIELD, MI 48034-8401
(248) 423-0903
(248) 423-0905
Mailing address
6431 BAUERVIC BLVD, WEST BLOOMFIELD, MI 48322-2237
(248) 851-0635
(248) 851-6463
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301039465
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2120509
—
MI
Enumeration date
03/24/2006
Last updated
02/08/2017
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