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Individual

ALVA WEAVER WHITEHEAD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
204 E CHEVES ST, FLORENCE, SC 29506-2604
(843) 777-7603
(843) 662-2474
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-7603
(843) 662-2474

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21244
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202935692
WRK. COMP. ID NO.
SC
05
212442
SC
Enumeration date
02/06/2006
Last updated
03/25/2009
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