Individual
DR. MICHAEL DAVID WHITING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
913 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 819-7103
(208) 763-3203
Mailing address
14775 N KIMO CT, SUITE B, RATHDRUM, ID 83858-8762
(208) 687-5627
(208) 687-5628
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8126
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010029526
REGENCE BLUE SHIELD HS65
ID
01
—
171111
LABOR AND INDUSTRIES
WA
Enumeration date
07/05/2006
Last updated
05/15/2020
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