Individual
MICHAEL E WHOBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1314 E WALNUT ST, WASHINGTON, IN 47501-2120
(812) 254-2760
(812) 254-8636
Mailing address
PO BOX 32, WASHINGTON, IN 47501-0032
(812) 254-2760
(812) 254-8636
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28066860A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190468
ANTHEM
IN
05
—
200195480
—
IN
Enumeration date
04/05/2006
Last updated
03/30/2010
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