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Individual

DR. CHESTER B WHITLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 516 DELAWARE STREET SE, ROOM 4-100, MINNEAPOLIS, MN 55455
(612) 626-6777
Mailing address
720 WASHINGTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414-2924
(612) 884-0649

Taxonomy

Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
26620
MN
208000000X
Pediatrics Physician
Primary
26620
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0055369
MT
05
0963116
IA
01
1009355
PREFERREDONE
01
100956
UCARE
01
1224617
MEDICA - CHOICE
01
1270277
MEDICA - PRIMARY
01
2T335WH
BLUE CROSS BLUE SHIELD
01
604688
ARAZ
05
711378100
MN
01
HP14681
HEALTHPARTNERS
Enumeration date
11/13/2006
Last updated
04/18/2012
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