Individual
DONALD A WHITING III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
EXIT 102 OFF I-40 1/2 MILE SOUTH, SAN FIDEL, NM 87049-0130
(505) 552-5385
(505) 552-5828
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5385
(505) 552-5828
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
I7010693
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
01/18/2012
Last updated
01/18/2012
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