Individual
RUSSELL S WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
L9013
TX
207RC0000X
Cardiovascular Disease Physician
Primary
MD.9524
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101301
—
AL
01
—
51548442
BCBS OF AL
AL
Enumeration date
08/09/2005
Last updated
10/01/2009
Update your record
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