Individual
ANDREW E WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
611 2ND ST # C, MARIETTA, OH 45750-2123
(740) 373-8756
(740) 373-0091
Mailing address
611 2ND ST, MARIETTA, OH 45750-2123
(740) 373-8756
(740) 373-0091
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.002927RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0242396
—
OH
Enumeration date
05/06/2009
Last updated
02/17/2025
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