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Individual

DR. MARY CHRISTINE WHITNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 584-4861
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 584-4861

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01065579A
IN
207P00000X
Emergency Medicine Physician
Primary
DR.0050033
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000659993
ANTHEM BC/BS
IN
01
000000670714
ANTHEM BC/BS
IN
05
200987460A
IN
05
83401563
CO
01
P00837117
RAILROAD MEDICARE
IN
01
P00852082
RAILROAD MEDICARE
IN
Enumeration date
06/04/2007
Last updated
06/23/2016
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