Individual
DR. DOUGLAS WAYNE WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 W SAINT JOHN ST, SPARTANBURG, SC 29306-5179
(864) 342-7070
Mailing address
101 W SAINT JOHN ST, SPARTANBURG, SC 29306-5179
(864) 342-7070
(833) 638-0121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15978
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159786
—
SC
01
—
1880582
CIGNA ID
SC
01
—
5655029
AETNA ID
SC
01
—
571004971012
BCBS OF SC ID
SC
01
—
80109539
RR MEDICARE
SC
Enumeration date
06/18/2006
Last updated
06/03/2021
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