Individual
DR. KENNETH CLIFFORD WHITHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1899 EIDER CT, TALLAHASSEE, FL 32308-4537
(850) 219-7640
Mailing address
1899 EIDER COURT, TALLAHASSEE, FL 32308-4537
(850) 219-7640
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD.29340
AL
390200000X
Student in an Organized Health Care Education/Training Program
R9321
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME 109950
ME LICENCE NUMBER
FL
Enumeration date
10/02/2006
Last updated
06/06/2011
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