Individual
ROBERT F WHITESIDES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2829 E HIGHWAY 76, MULLINS, SC 29574-6035
(843) 431-2000
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7980
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079809
—
SC
05
—
890627I
—
NC
Enumeration date
11/02/2005
Last updated
10/16/2008
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