Individual
DENNIS C WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1721 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801-3637
(906) 774-1313
(906) 774-5639
Mailing address
PO BOX 549, IRON MOUNTAIN, MI 49801-0549
(906) 774-1313
(906) 774-5639
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301038973
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102200331
BCBS MI
MI
05
—
1936052
—
MI
05
—
31656600
—
WI
01
—
930033054
RR MEDICARE
MI
Enumeration date
12/30/2005
Last updated
07/10/2012
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