Individual
DOUGLAS DELEON WHITFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2430 EMERALD PL STE 201, GREENVILLE, NC 27834-5743
(252) 752-2140
Mailing address
2430 EMERALD PL STE 201, GREENVILLE, NC 27834-5743
(252) 752-2140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
074005
NC
367500000X
Certified Registered Nurse Anesthetist
036848
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
1863
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811907959
TRICARE
NC
05
—
8050613
—
NC
01
—
P00601431
RAILROAD MEDICARE
NC
Enumeration date
08/09/2006
Last updated
12/13/2024
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